Multiple organizations advise healthcare providers to periodically ask sexually active adolescents and adults about sexual behaviors that may increase their risk for HIV or other sexually transmitted infections (STIs), but many don’t, according to new research.
Data from the National Survey of Family Growth for 2011-2015 show that only 47% of females and just 23% of males aged 15 to 44 years who had recently engaged in sexual activity received a sexual risk assessment from a physician or other healthcare provider in the past year.
Factors affecting the rates at which patients received a sexual risk assessment included age, being of Hispanic origin and race, sexual orientation, income, and health insurance status, according to the report published online March 29 in National Health Statistics Reports.
Roughly 65% of females aged 15 to 19 years who had recently engaged in sexual activity received a sexual risk assessment in the past year, as did 63% of women aged 20 to 24. The percentage was lower (41%) for women aged 25 to 44 years, notes author Casey Copen, MPH, PhD, with the Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics, .
Sexual risk assessment was more common among Hispanic and non-Hispanic black females (59% and 55%) compared with non-Hispanic white females (43%). There were no marked differences by sexual orientation in the percentages of female patients who received a sexual risk assessment.
Women aged 20 to 44 whose incomes were lower than 300% of the federal poverty level were more apt to receive a sexual risk assessment than women with incomes at or above this level (49% vs 39%). More women aged 20 to 44 who had public health insurance received a sexual risk assessment (53%) compared with their peers with private health insurance (42%) or no health insurance (46%).
Among Males
Results show that roughly 44% of males aged 15 to 19 who had recently engaged in sexual activity received a sexual risk assessment in the past year, compared with 31% of men aged 20 to 24 years and just 18% of men aged 25 to 44 years.
Forty percent of non-Hispanic black males aged 15 to 44 received a sexual risk assessment in the past year, which was higher than the percentages for Hispanic (26%) and non-Hispanic white (18%) males.
A higher percentage of males in the 15 to 44 age bracket who identified as homosexual or gay (47%) or as bisexual (39%) received a sexual risk assessment compared with those who identified as heterosexual or straight (22%). More men aged 20 to 44 whose incomes were lower than 300% of the federal poverty level (23%) received a sexual risk assessment in the past year than their peers at or above this level (18%).
Roughly 30% of men aged 20 to 44 with public health insurance received a sexual risk assessment in the past year compared with 19% of those with private health insurance and 18% of those with no health insurance.
For males and females, sexual risk assessment was more common for those with two or more opposite-sex partners and for males who had a male sex partner or had engaged in any HIV risk–related sexual behaviors in the past year. Roughly 46% of males and 56% of females reported HIV risk–related sexual behaviors in the prior year. Among both males and females, HIV/STI testing within the past year was more common in those who had undergone a sexual risk assessment in the past year.
“A sexual risk assessment is a primary prevention tool that can help identify persons at risk of HIV/STI. Findings in this report may help inform HIV/STI prevention efforts within the health care setting,” writes Copen.
The CDC estimates that 20 million new STIs occur in the United States each year. Nearly half occur among those aged 15 to 24 years.
Natl Health Stat Report. Published online March 29, 2018. Full text
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