Family doctors should consider screening young adults for sexually transmitted diseases (STDs) even if they claim abstinence, researchers suggest in a new report released in the Pediatrics Journal early this month.
After testing approximately 14,000 young adults with an average age of 22, the researchers found over 10 percent of participants who tested positive for STDs claimed they hadn’t had sex in the last year. Moreover, a fraction of those individuals claimed they were virgins.
Participants completed online questionnaires in 2001 and 2002 about their sexual activity and provided urine samples that were tested for chlamydia, gonorrhea and trichomonas vaginalis. The study included a nearly even number of men and women, as well as 67 percent Whites and 16 percent Blacks.
Just over 960 participants tested positive for one of the three STDs, but 118 of them had claimed abstinence and 60 said they had never been sexually active.
Age, race, gender and level of education were not associated with the discrepancy, the researchers noted.
“This counterintuitive finding suggests that sole reliance on young adults’ self-reported penile/vaginal sexual activity as a marker for STD acquisition risk may be imprecise, and further, could be problematic,” researchers said in the report.
Dr. Renata Arrington-Sanders, assistant professor of Adolescent Health at Johns Hopkins Children’s Center, said the discrepancies between the self-reports and test-results present a common problem.
“People underreport in general,” she told the AFRO. “Some people don’t feel as comfortable reporting in a survey…or speaking about STD’s in a clinical setting with a provider.”
She said recall-bias could have also played a factor in the study. If people don’t have sex often, she said, they assume it has been longer between intimacies than it really has been.
Arrington-Sanders said it might be more effective to ask participants about sexual activity in the last three months instead of 12.
She also noted shortcomings in the research, including a two-month gap between the time participants answered questions about sexual activity and when they were tested, meaning the teens could have truthfully reported sexual inactivity, and had sex in the time in between. Also, the survey’s definition of sex was limited to heterosexual intercourse, which may have left out some sexually-active homosexual participants.
In their conclusions, the researchers suggest all young people, “whether their sexual history indicates they are recently sexual active or not, should be tested for prevalent STDs, like those assayed in this study.”
Dr. Arrington-Sanders said she doesn’t endorse universal STD screening, but agrees health providers should not solely rely on self-reports of sexual activity. “They should develop a rapport with patients…and use other indicators to determine if they are engaging in risky behavior and screening is necessary,” she said.
Also noteworthy in the study, Black participants were more than six times more likely than White participants to test positive for one of the venereal diseases and risks were also higher for participants without a high school degree.
