Racial/Ethnic Disparities in Female Sexual Health from Adolescence to Young Adulthood: How Adolescent Characteristics Matter?

Trends in Gonorrhea and Chlamydia Testing and Infections Across the COVID-19 Pandemic in Adolescents and Young Adults in an Integrated Health System

PURPOSE

The COVID-19 pandemic impacted testing and incidence of sexually transmitted infections (STIs), with some studies showing uneven effects across sociodemographic groups. We aim to determine whether rates of gonorrhea and chlamydia testing and infections were affected by the pandemic, overall and by subgroups, defined by sociodemographic factors and comorbidities.

METHODS

We conducted a retrospective cohort study from January 1, 2016, through December 31, 2022, among adolescents and young adults ages 15-29 years within Kaiser Permanente Northern California (KPNC). We determined the rate of testing for gonorrhea/chlamydia, and the incident rates of infections before and during the COVID-19 pandemic by sociodemographic factors. We compared incidence rates of gonorrhea/chlamydia testing and infection before and during the pandemic using Poisson regression.

RESULTS

Gonorrhea/chlamydia testing during the pandemic was 19% lower than prepandemic baseline. Testing among Black patients was 1.8-fold higher than White patients. Black patients had 5.5 and 3.6-fold higher rate of gonorrhea and chlamydia infections, respectively, compared with White patients. Patients living in more deprived neighborhoods also had higher rates of infection compared to those in the least deprived neighborhoods. In multivariable analyses stratified by the period before and during the COVID-19 pandemic, there were no significant differences in the incidence rate ratios of testing or infections for any specific sociodemographic factor.

DISCUSSION

STI testing in adolescents and young adults dropped dramatically after the start of the pandemic and has not recovered to its prior levels. Preexisting disparities in STI testing and infections were not exacerbated by the pandemic.

Alcohol drinking patterns and occurrence of genital warts among Danish adolescents

BACKGROUND

Under the influence of alcohol adolescents are more prone to engage in unprotected sex, which increases the risk of acquiring genital warts. The study aim was to examine whether alcohol consumption among adolescents is associated with acquiring genital warts.

METHODS

Health behavior data were extracted from the Danish National Youth Study 2014. Complete data were available for 63,648 students. Number of binge drinking episodes in the past 30 days, frequency of drinking on weekends and total number of drinks consumed during 7-day week were collected by a questionnaire. Information on genital warts for the period between filling the questionnaire in 2014 and December 31, 2018 was retrieved from the Danish National Prescription Register and Danish National Patient Register.

RESULTS

Adjusted analysis showed that, compared to students who did not drink alcohol, increasing frequency of binge drinking in the past 30 days was independently associated with greater hazard of acquiring genital warts (1-3 times hazard ratio [HR]: 1.36, 95 % confidence interval [CI]: 1.09-1.69; 4-6 times HR: 1.55, 95 % CI: 1.22-1.96; >6 times HR: 1.84, 95 % CI 1.39-2.45). Compared to students who did not drink alcohol, consistent alcohol drinking every weekend was associated with greater risk of developing genital warts (HR: 1.62, 95 % CI: 1.20-2.17). Total weekly number of alcohol drinks consumed was not associated with occurrence of genital warts.

CONCLUSION

Increased alcohol intake was associated with occurrence of genital warts over 4 year of follow-up. There is an urgent need for change of excessive alcohol intake tendencies among adolescents.