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What Sexually Transmitted Disease Screening Method Does the Adolescent Prefer?
Adolescents' Attitudes Toward First-Void Urine, Self-collected Vaginal Swab, and Pelvic Examination
Michelle Serlin, MD;
Mary-Ann Shafer, MD;
Kathleen Tebb, PhD;
Afua-Adoma Gyamfi, BS;
Jeanne Moncada, MT;
Julius Schachter, PhD;
Charles Wibbelsman, MD
Arch Pediatr Adolesc Med. 2002;156:588-591.
Objective To assess sexually active adolescents' attitudes toward 3 screening
collection techniques for detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis using first-void urine (FVU), self-collected
vaginal swab specimens, and pelvic examination with clinician-collected endocervical
swab specimens.
Design Participants completed a preexamination health survey, provided FVU
and self-collected vaginal swab samples, and had a pelvic examination with
endocervical swab specimen collection. In a confidential postexamination interview,
patients ranked the 3 screening techniques according to preference and responded
to qualitative positive and negative descriptors to evaluate each technique.
Setting San Francisco area health maintenance organization and university clinics.
Participants A convenience sample of 155 ethnically diverse females aged 12 to 21
years, who were sexually active and were to have a pelvic examination.
Main Outcome Measures Adolescents' preferences for and evaluations of 3 sexually transmitted
disease screening techniques.
Results Participants preferred the FVU test for sexually transmitted disease
screening over the pelvic examination and the self-administered vaginal swab
test (P<.001). These results were consistent when
controlling for potentially mitigating experiences, including previous pelvic
examination, tampon or condom use, and prior pregnancy. In evaluating what
they liked and disliked about each of the 3 screening methods, participants
described the FVU most positively, the pelvic examination most negatively,
and the vaginal swab technique slightly less positively than the FVU.
Conclusion Most sexually active adolescents attending clinics for pelvic examination
prefer to be screened for sexually transmitted diseases first by the FVU,
second by the self-collected vaginal swab test, and last by the pelvic examination.
From the Children's Hospital, Oakland, Calif (Dr Serlin), Division
of Adolescent Medicine, Department of Pediatrics (Drs Shafer and Tebb and
Ms Gyamfi); Department of Laboratory Medicine (Dr Schachter and Ms Moncada),
School of Medicine, University of California–San Francisco, and Kaiser
Permanente (Dr Wibbelsman), San Francisco.
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