Forget the routine pelvic exam. When the goal is to prevent the serious complications of sexually transmitted diseases (STDs) in adolescent girls, a simple urine test will reach more teens and at a lower cost.
That is the conclusion drawn by adolescent health specialist Mary-Ann Shafer, MD, and her UC San Francisco colleagues in an article published in the February 14, 1999 issue of the Archives of Pediatric Adolescent Medicine. "New technology allows laboratories to very accurately detect signs of chlamydia and gonorrhea in urine samples, Shafer said. This urine test is nearly as effective as the traditional STD tests for gonorrhea and chlamydia using samples taken from the woman's cervix."
"We know from earlier research that as many as one-third of adolescent girls and women avoid screening for STDs because they fear the embarrassment and pain of a pelvic exam, which is required for the traditional tests," Shafer said. "So in the real world, urine tests will detect more cases of asymptomatic STDs."
The UCSF researchers calculated that an annual urine test to screen for STDs among the estimated five million sexually active 15 to 19 year old young women in the U.S would save $202.5 million each year in comparison to universal annual pelvic exams, the method currently recommended by public health experts.
TESTS FOR REAL-WORLD TEENS
"Probably the most important application of urine tests is their use on young women and men who have chlamydia or gonorrhea, but have no symptoms at all," Shafer said. To detect infection, urine based testing does not require the invasive and often uncomfortable pelvic exam for girls or a swab test which can be painful for boys. That means teens can be screened outside of traditional clinic settings -- in school based clinics, recreational centers, and other settings where teens congregate.
When STDs are detected in the early stages, before symptoms begin, patients can
be treated with antibiotics to reduce
Contact: Janet Basu
University of California - San Francisco