(116) The Effect of Race in Screening and Incidence of Sexually Transmitted Infections in Adolescents with Disabilities

Background: Individuals with disabilities experience a higher prevalence of sexually transmitted infections (STIs) compared to their counterparts without disabilities, but studies show that adolescents with disabilities are screened for STIs at a lower rate. There is limited data on the role race plays in the screening for and incidence of STIs in adolescents with disabilities. The aim of this study is to explore the interplay of race and STIs in adolescents with disabilities.

Methods: A retrospective cohort study was conducted of adolescent females ages 16-21 attending well-child visits at an academic health center from July 2021 - September 2024. Data collected included demographics, disability status, STI tests performed, and results. Disability status was defined using the Children with Disabilities Algorithm, which uses ICD-9 codes to classify disabilities as physical, sensory, developmental/behavioral, psychological, and intellectual. Outcome measures included STI testing, incidence of STIs among adolescents with disabilities, and race. Chi Square tests were used to measure association. This study was exempt by the IRB.

Results: 3,559 adolescents were included. Having any disability was associated with lower odds of STI screening overall, (p < 0.001) unadjusted and adjusting for race, ethnicity and non-English language. Compared to patients without disabilities, when evaluating specific disability types, patients with physical, developmental and intellectual disabilities had a lower screening rate (p < 0.039, p< 0.001, p< 0.028, respectively) whereas patients with sensory and psychological disabilities had a higher screening rate (p < 0.064, p< 0.025, respectively).

Patients of non-black minority race (NBMR) with disabilities had a higher rate of STI screening overall than patients with disabilities who were Black or White (p < 0.048). Among patients with psychological disabilities, White patients had a higher likelihood of STI testing than patients of other races (p < 0.018). Of those tested, there was no difference in overall incidence of positive STI’s when comparing patients with and without disabilities (2.0 vs 2.1%, p< 0.86). Black patients, with and without disabilities, had a higher rate of STIs in both cohorts when compared to other races (p < 0.001).

Conclusions: Adolescents with disabilities are screened for STIs at lower rates overall than their able-bodied counterparts. Among patients with disabilities, patients of NBMR had higher rates of screening than Black or White patients while Black patients had a higher overall prevalence of STIs. More education is needed to achieve equity in STI testing for all adolescents.