ARE ADOLESCENTS ACCURATE IN SELF-REPORT OF FREQUENCIES OF SEXUALLY-TRANSMITTED DISEASES AND PREGNANCIES

Purpose: Many surveys of adolescent behavior are dependent on self-rep orted data. We sought to assess the accuracy of adolescent self-report of sexually transmitted diseases (STDs) and pregnancies. Methods: We randomly selected 149 (118 females, 31 males) adolescents to participa te in this accuracy study. Follow-up questionnaires were administered to the 126 patients (99 females, 27 males) who returned after enrollme nt. Patients were asked about STDs and pregnancies during the follow-u p period which ranged from 6 months to 1 year. All patient charts were reviewed to validate post-testing history. Results: Return visits wer e made by 126 patients (84%). Fifty-one (40%) denied having had an STD at all during the follow-up period but were found to have had at leas t one STD. Another 11 (9%) admitted having had an STD but had multiple STDs in excess of what they reported. Only 46% of the patients provid ed accurate information on the follow-up questionnaire. Of the 99 girl s who returned for follow-up, the inaccurate patients (10%) consisted of 9 who reported no visits for a pregnancy but had a pregnancy docume nted in their charts and I who underreported her number of pregnancies . Reliability analysis of the accuracy of STD and pregnancy self-repor t for our patients showed kappas ranging from 0.185 to 0.413 (slight a nd fair to moderate, respectively). Pearson correlation coefficients w ere 0.3107 and 0.4364 for STD and pregnancy, respectively. Conclusions : Our patients' histories of visits for STDs and pregnancies are often not substantiated by review of their medical records. The reason for the inaccuracies in self-report of sexual behaviors is unclear. Furthe r research in this area should be done. Physicians must confirm patien t history concerning sexual practices through appropriate record revie w and medical evaluation. (C) Society for Adolescent Medicine.