DELIVERY OF STD HIV PREVENTIVE SERVICES TO ADOLESCENTS BY PRIMARY-CARE PHYSICIANS/

Purpose: To document the rates of STD/HIV preventive services delivere d to adolescents by primary care physicians in California, and to iden tify variation owing to physician and practice-related factors. Method s: A stratified random sample of California internists, family physici ans, obstetrician-gynecologists, and pediatricians was drawn from the AMA Masterfile and surveyed by mail about their practices with regard to STD/HIV prevention for 15-18-year-old adolescent patients. Sixty pe rcent of eligible physicians responded; the final sample was 1217 phys icians. Results: Results showed that 40% of physicians reported screen ing all of their adolescent patients for sexual activity and 31% repor ted educating all of their adolescent patients about STD/HIV transmiss ion. For their sexually active adolescent patients, 36% of physicians always provided STD/HIV education, 17% always screened for number of p revious sexual partners; 12% always screened for sexual orientation; a nd 10% always screened for frequency of casual sex. Four percent of th e physicians reported that they always provided condoms for their sexu ally active adolescent patients; 81% never provided condoms. Higher le vels of preventive services delivery were associated with female physi cian gender, specialization in obstetrics-gynecology, and more recent date of medical school graduation. Physicians practicing in health mai ntenance organizations reported providing significantly higher rates o f preventive services to sexually active adolescents than did physicia ns in private practice. Conclusions: Primary care physicians provide S TD/HIV preventive services to adolescents at rates far below those rec ommended by current guidelines. Areas where additional research would be informative are highlighted.