Many Young Women Uncomfortable, Uneducated About STD Testing Process

ATLANTA – Many young women are uncomfortable talking to their health care providers about their sexual health and lack accurate information about the STD testing process, based on the results of a survey on STD testing beliefs.

In the study presented at a conference on STD prevention sponsored by the U.S. Centers for Disease Control and Prevention, Dr. Heather R. Royer of the University of Wisconsin, Madison, recruited 302 women aged 18-24 years: 201 women from four women’s health clinics and 101 women from a university class.

Participants were an average of 20 years old; 78% were white, 13% were nonwhite, and 5% were multiple races; this information was missing for the remaining 4%. The group was well educated, with 75% having some college or technical school experience. Nearly two-thirds of participants (62%) had undergone any prior STD testing, with 13% (44 women) having been diagnosed with an STD, including 23 women with HPV and 13 women with chlamydia.

The vast majority of respondents (84%) said that they would rather not go to their family doctor for STD testing; 79% said that it is easier to talk with an STD testing specialist than with a family doctor. Moreover, 88% said that it is easier to talk with a female health care provider than a male.

Nearly a quarter of participants said that they feel embarrassed about talking with a health care provider about STD testing (23%) and that talking with a health care provider about STD testing is difficult (22%).

Dr. Royer found significant associations between never having been tested for STDs and reporting embarrassment about sexual health communication. Women who had never been tested were more than twice as likely as those who had been tested to respond that they feel embarrassed about discussing STD testing (odds ratio, 2.37); that talking about STD testing is difficult (OR, 2.48); or that filling out forms about their sexual past is embarrassing (OR, 2.06).

Women also lacked knowledge about the STD testing process: 41% assumed that STD testing includes screening for “all STDs.” Regarding specific pathogens, participants thought that testing would include chlamydia (51%), gonorrhea (47%), syphilis (29%), Trichomonas species (21%), herpes simplex virus (28%), HPV (18%), HIV/AIDS (16%), and hepatitis B (13%).

In an interview, Dr. Royer explained that if women seeking STD testing believe that they are being tested for “all STDs,” they may inaccurately believe that they have tested negative for pathogens that have not been included, such as HIV or herpes.

Many women also thought that if the health care provider performs a Pap smear, they are being tested for STDs, including HPV (41%), gonorrhea (23%), chlamydia (26%), Trichomonas species (17%), syphilis (15%), herpes (14%), hepatitis B (4%), HIV/AIDS (2%), and “all STDs” (6%).

“It is striking that a quarter of women think that they are being tested for chlamydia and gonorrhea during a Pap smear,” commented Dr. Royer. “If women think they are automatically being tested for STDs during their annual Pap smear ... they would have no reason to ask to be tested.”

Finally, many women believed that STDs could be detected by a visual inspection of the genital area, most notably for herpes (77%), but also for gonorrhea (35%), chlamydia (32%), syphilis (30%), HPV (19%), Trichomonas species (15%), and hepatitis B (1%).

Dr. Royer concluded that health care providers must be cognizant of women’s discomfort in discussing their sexual health. “Providers should consider ways to help young women reframe the sexual health discussion from one of embarrassment to one of empowerment,” she concluded.

Dr. Royer said she had no conflicts of interest.

ATLANTA – Many young women are uncomfortable talking to their health care providers about their sexual health and lack accurate information about the STD testing process, based on the results of a survey on STD testing beliefs.

In the study presented at a conference on STD prevention sponsored by the U.S. Centers for Disease Control and Prevention, Dr. Heather R. Royer of the University of Wisconsin, Madison, recruited 302 women aged 18-24 years: 201 women from four women’s health clinics and 101 women from a university class.

Participants were an average of 20 years old; 78% were white, 13% were nonwhite, and 5% were multiple races; this information was missing for the remaining 4%. The group was well educated, with 75% having some college or technical school experience. Nearly two-thirds of participants (62%) had undergone any prior STD testing, with 13% (44 women) having been diagnosed with an STD, including 23 women with HPV and 13 women with chlamydia.

The vast majority of respondents (84%) said that they would rather not go to their family doctor for STD testing; 79% said that it is easier to talk with an STD testing specialist than with a family doctor. Moreover, 88% said that it is easier to talk with a female health care provider than a male.

Nearly a quarter of participants said that they feel embarrassed about talking with a health care provider about STD testing (23%) and that talking with a health care provider about STD testing is difficult (22%).

Dr. Royer found significant associations between never having been tested for STDs and reporting embarrassment about sexual health communication. Women who had never been tested were more than twice as likely as those who had been tested to respond that they feel embarrassed about discussing STD testing (odds ratio, 2.37); that talking about STD testing is difficult (OR, 2.48); or that filling out forms about their sexual past is embarrassing (OR, 2.06).

Women also lacked knowledge about the STD testing process: 41% assumed that STD testing includes screening for “all STDs.” Regarding specific pathogens, participants thought that testing would include chlamydia (51%), gonorrhea (47%), syphilis (29%), Trichomonas species (21%), herpes simplex virus (28%), HPV (18%), HIV/AIDS (16%), and hepatitis B (13%).

In an interview, Dr. Royer explained that if women seeking STD testing believe that they are being tested for “all STDs,” they may inaccurately believe that they have tested negative for pathogens that have not been included, such as HIV or herpes.

Many women also thought that if the health care provider performs a Pap smear, they are being tested for STDs, including HPV (41%), gonorrhea (23%), chlamydia (26%), Trichomonas species (17%), syphilis (15%), herpes (14%), hepatitis B (4%), HIV/AIDS (2%), and “all STDs” (6%).

“It is striking that a quarter of women think that they are being tested for chlamydia and gonorrhea during a Pap smear,” commented Dr. Royer. “If women think they are automatically being tested for STDs during their annual Pap smear ... they would have no reason to ask to be tested.”

Finally, many women believed that STDs could be detected by a visual inspection of the genital area, most notably for herpes (77%), but also for gonorrhea (35%), chlamydia (32%), syphilis (30%), HPV (19%), Trichomonas species (15%), and hepatitis B (1%).

Dr. Royer concluded that health care providers must be cognizant of women’s discomfort in discussing their sexual health. “Providers should consider ways to help young women reframe the sexual health discussion from one of embarrassment to one of empowerment,” she concluded.

Dr. Royer said she had no conflicts of interest.

ATLANTA – Many young women are uncomfortable talking to their health care providers about their sexual health and lack accurate information about the STD testing process, based on the results of a survey on STD testing beliefs.

In the study presented at a conference on STD prevention sponsored by the U.S. Centers for Disease Control and Prevention, Dr. Heather R. Royer of the University of Wisconsin, Madison, recruited 302 women aged 18-24 years: 201 women from four women’s health clinics and 101 women from a university class.

Participants were an average of 20 years old; 78% were white, 13% were nonwhite, and 5% were multiple races; this information was missing for the remaining 4%. The group was well educated, with 75% having some college or technical school experience. Nearly two-thirds of participants (62%) had undergone any prior STD testing, with 13% (44 women) having been diagnosed with an STD, including 23 women with HPV and 13 women with chlamydia.

The vast majority of respondents (84%) said that they would rather not go to their family doctor for STD testing; 79% said that it is easier to talk with an STD testing specialist than with a family doctor. Moreover, 88% said that it is easier to talk with a female health care provider than a male.

Nearly a quarter of participants said that they feel embarrassed about talking with a health care provider about STD testing (23%) and that talking with a health care provider about STD testing is difficult (22%).

Dr. Royer found significant associations between never having been tested for STDs and reporting embarrassment about sexual health communication. Women who had never been tested were more than twice as likely as those who had been tested to respond that they feel embarrassed about discussing STD testing (odds ratio, 2.37); that talking about STD testing is difficult (OR, 2.48); or that filling out forms about their sexual past is embarrassing (OR, 2.06).

Women also lacked knowledge about the STD testing process: 41% assumed that STD testing includes screening for “all STDs.” Regarding specific pathogens, participants thought that testing would include chlamydia (51%), gonorrhea (47%), syphilis (29%), Trichomonas species (21%), herpes simplex virus (28%), HPV (18%), HIV/AIDS (16%), and hepatitis B (13%).

In an interview, Dr. Royer explained that if women seeking STD testing believe that they are being tested for “all STDs,” they may inaccurately believe that they have tested negative for pathogens that have not been included, such as HIV or herpes.

Many women also thought that if the health care provider performs a Pap smear, they are being tested for STDs, including HPV (41%), gonorrhea (23%), chlamydia (26%), Trichomonas species (17%), syphilis (15%), herpes (14%), hepatitis B (4%), HIV/AIDS (2%), and “all STDs” (6%).

“It is striking that a quarter of women think that they are being tested for chlamydia and gonorrhea during a Pap smear,” commented Dr. Royer. “If women think they are automatically being tested for STDs during their annual Pap smear ... they would have no reason to ask to be tested.”

Finally, many women believed that STDs could be detected by a visual inspection of the genital area, most notably for herpes (77%), but also for gonorrhea (35%), chlamydia (32%), syphilis (30%), HPV (19%), Trichomonas species (15%), and hepatitis B (1%).

Dr. Royer concluded that health care providers must be cognizant of women’s discomfort in discussing their sexual health. “Providers should consider ways to help young women reframe the sexual health discussion from one of embarrassment to one of empowerment,” she concluded.

Dr. Royer said she had no conflicts of interest.