Purpose: Sexual minority women and racial/ethnic minority women in the United States are at increased risk for sexually transmitted infections (STIs) and unintended pregnancy. Yet, we know little about STI/HIV testing and contraceptive care among women who have sex with women only and women who have sex with both women and men, and who are racial/ethnic minorities. This study examined receipt of STI/HIV testing and contraceptive care among sexually active adolescent women by sex of sexual contact(s) and race/ethnicity.
Methods: Our sample included 2,149 sexually active adolescent women from the National Survey of Family Growth (2011-2019). We examined receipt of sexual and reproductive health (SRH) services by sex of sexual contact(s) and race/ethnicity: STI and HIV testing, contraceptive counseling, contraceptive method, emergency contraception (EC) counseling, and EC method.
Results: Service receipt was low for all adolescent women, with disparities by sex of sexual contact(s) and by race/ethnicity. Women who have sex with women only had the lowest rates across all services; women who have sex with both women and men had higher rates of STI and HIV testing and EC counseling than women who have sex with men only. Non-Hispanic Black women had higher rates of STI and HIV testing than non-Hispanic White peers, and non-Hispanic Black and Hispanic women had lower rates of contraception method receipt than their non-Hispanic White peers. Racial/ethnic disparities persisted when results were stratified by sex of sexual contact(s).
Discussion: There is an unmet need for improved SRH service delivery for all adolescent women and for services that are not biased by sex of sexual contact(s) and race/ethnicity.
Keywords: Adolescent health; Bisexual; Contraception; HIV; Lesbian; Minority health; Racial and ethnic minorities; Sexual health; Sexually transmitted infections; Women who have sex with women.
Copyright © 2022 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.