Self-reported sexual history unreliable for predicting STD status

DiClemente RJ. Pediatrics. 2011;127:208-213.

  • Infectious Diseases in Children, February 2011

Routine STD screening may be beneficial in reducing STD-related morbidity in young adults because there are some discrepancies between self-reported sexual behaviors and STD status, according to an online published study.

Ralph J. DiClemente, PhD, and colleagues from Emory University reported on findings derived from participants in the third wave of the National Longitudinal Study of Adolescent Health, a survey of more than 14,000 young adults who had responded to the survey and were also tested for STDs. The researchers said 10% of young adults with a laboratory-confirmed STD result reported that they abstained from sexual intercourse in the 12 months before assessment and STD testing. Of all the participants in the third wave who provided a urine sample for screening, 964 (6%) tested positive for one of three STDs — chlamydia, gonorrhea or trichomoniasis. The researchers said about 6% of the STD-positive participants reported no lifetime history of penile or vaginal sex.

“From a clinical standpoint, the discrepancies between STD positivity and self-reported sexual behavior identified in this nationally representative sample suggest that routine STD screening may be beneficial and necessary to reduce STD morbidity,” the researchers wrote. “In addition, given that no sociodemographic characteristics differentiated young adults with discrepant results from those without, routine screening for common STDs may be useful for all young adults, regardless of self-reported sexual history, rage, gender or age.”

The researchers noted some study limitations; notably, the absence of a baseline measure of STD status and the use of urine specimens to identify STD status. However, they said the study conclusions point to the importance of screening for STDs.

“If pediatricians and adolescent medicine physicians do not test all young people, there are likely a substantial number of missed cases of STDs that will go undiagnosed, untreated, and spread to future sex partners,” the researchers said.

Disclosures: The researchers reported no relevant financial disclosures.

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