The XX Factor

Young People Get Nearly Half the Country’s STIs, But Few Get Tested

Many doctors just don’t bring it up.

According to a data analysis published in the May issue of the Journal of Adolescent Health, teens are not getting tested for STIs nearly enough. The study, a reevaluation of information gleaned from a 2013 Get Yourself Tested survey, found that just 11.5 percent of teens and young adults aged 15 to 25 had received an STI test within the previous year.

Out of the 3,953 people included in the sample, 16.6 percent of women had gotten tested, compared to just 6.1 percent of men. Younger teens really skewed those numbers downward: People aged 18 to 25 were far more likely to have taken an STI test (24.3 percent of women; 9.1 percent of men) than teens aged 15 to 17 (6.7 percent of girls; 2.4 percent of boys).

When researchers cut out young people who said they’d never had sex, those numbers improved: 27 percent of young women who’d had sex and 9.8 percent of young men who’d had sex reported getting screened for STIs in the past 12 months. Still, this data is reason for some concern, since people aged 15 to 24 make up almost half of the 20 million annual new STI diagnoses in the U.S.—despite the fact that they only make up a quarter of the sexually active population.

So why aren’t they getting tested? Fear of parental wrath or judgment probably plays a part: People who were completely financially independent from their parents had higher testing rates than those who reported any degree of dependence. Many young people also reported fearing for their privacy, though young men who hadn’t been tested were far more likely than their female peers—60.1 percent to 39.9 percent—to say they’d avoided getting tested for reasons of confidentiality.

Two interesting bits of demographic data: Non-Hispanic black men had the best testing rate among male participants, 15.6 percent, and among female participants, those with an annual household income of less than $50,000 were about 7 points more likely to have gotten tested than those with higher household incomes. As I’ve previously reported, white and rural teens in the U.S. are getting less education about birth control than urban teens and teens of color; it’s possible that STI testing information comes right alongside contraceptive education, and that pregnancy prevention programs targeted at young women in low-income communities include provisions for STI testing. A previous study has suggested that a new push to get teens on long-acting reversible contraception, which has been partially credited with a precipitous drop in the teen birth rate, needs to be better integrated with STI education as teens forgo condoms for more reliable forms of birth control that don’t protect against STIs.

The new numbers suggest two ways to get more young people tested, treated, and using protection. One is better education about risk factors: A full 41.8 percent of young people who’d had sex but never been tested said they just didn’t feel they were at risk of contracting an STI. But medical providers need to get on board with proactive sexual-health care for teens and young adults. A third of sexually experienced, never-tested survey participants offered this explanation for why they’d never gotten tested: Their doctor never brought it up.