USING REPRODUCTIVE HEALTH VISITS TO ENGAGE ADOLESCENT AND YOUNG ADULT WOMEN IN PRIMARY CARE

Purpose: Adolescent/Young Adult (AYA) primary care visits are an opportune time to address physical, psychological, and social influences on developing health behaviors. However, many AYAs do not receive primary care despite available guidelines for screening, immunizations, and annual physical exam...

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Bibliographic Details
Published in:Journal of adolescent health 2020-02, Vol.66 (2S), p.S112
Main Authors: Calihan, Jessica B, Tomaszewski, Kathy, Wheeler, Noah, Recto, Michelle Alexandra, Trent, Maria
Format: Article
Language:English
Subjects:
Acting
Birth control
Chart reviews
Chlamydia trachomatis
Condoms
Contraceptives
Family planning
Gonorrhea
Health behavior
Health services
HIV
Human immunodeficiency virus
Immunization
Medical screening
Medroxyprogesterone acetate
Patients
Physical examinations
Primary care
Reproductive health
Risk reduction
Sexual behavior
Sexual health
Sexually transmitted diseases
STD
Teenagers
Tests
Visits
Women
Young adults
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Summary:Purpose: Adolescent/Young Adult (AYA) primary care visits are an opportune time to address physical, psychological, and social influences on developing health behaviors. However, many AYAs do not receive primary care despite available guidelines for screening, immunizations, and annual physical exams. Frequent interactions with the healthcare system by AYA women for family planning and other reproductive health services may be used to improve engagement in care and promote wellness; however, less cumbersome methods may require less interaction with the healthcare system. The purpose of this research is to examine differences in clinic engagement, receipt of primary care, STI/HIV screening, and immunizations by contraceptive use. Methods: A retrospective chart review of AYA women who received sexual health risk reduction counseling by a health educator in an urban academic AYA clinic between February 2014 and February 2015. Participants included in the samples were non-pregnant primary care AYA patients aged 12 to 24 who reported using one of the following forms of contraception: no contraception, only condoms, long- (IUD, implant), medium- (Depo-Provera), or short- (pill, ring, patch) acting hormonal methods. Descriptive and bivariate analyses were used to examine the relationship between contraception use and measures of clinic engagement following the counseling visit, including receipt of an annual primary care well visit, gonorrhea/ chlamydia (GC/CT) and HIV screening, and immunizations. Results: Of the 413 patients included, 46.2% had a primary care visit, 52.5% received GC/CT screening, and 87.4% received appropriate immunizations. Most (72%) had been sexually active, 19.1% had a prior pregnancy, and 33% had a prior STI diagnosis. Seventy-one (17.2%) used long-acting, 102 (24.7%) used medium-acting, and 56 (13.6%) used short-acting contraception; 45 (10.9%) used condoms only, and 139 (33.7%) did not use contraception. Compared to AYA women using no contraception or condoms, those using hormonal contraception were more likely to have had a primary care visit (OR 1.68, 95% CI 1.14-2.49), physical exam (OR 1.62, 95% CI 1.07-2.45), and screening for GC/CT (RR 3.78, 95% CI 2.51-5.69) or HIV (OR 2.70, 95% CI 1.79-4.06) within the year. Specifically, Depo-Provera use was associated with receipt of an annual primary care visit (OR 2.31, 95% CI 1.41-3.79), GC/CT screening (OR 4.10, 95% CI 2.45-6.88), and HIV screening (OR 2.50, 95% CI 1.52-4.13) compared to t
ISSN:1054-139X
1879-1972