Incidence of sexually transmitted infections (STIs) is on the rise in the United States—particularly among adolescents. About half of STIs diagnosed in the United States occur among adolescents and young adults and approximately 1 in 4 adolescent females are diagnosed with an STI each year.1., 2., 3. As a result, several national organizations including the United States Preventive services Task Force (USPSTF), the American Academy of Pediatrics (AAP), and the Centers for Disease Control and Prevention (CDC), have released guidelines recommending screening for STIs in sexually active females under the age of 25 years.4., 5., 6. However, despite these guidelines, the majority of adolescents are not being screened.7

Barriers to STI screening in the adolescent population have been well-established and include cost, access to transportation, and concerns regarding confidentiality. In addition to patient barriers, the risk of infection in this population is not always adequately assessed by healthcare providers.8 Disparities in social determinants of health are associated with higher rates of STIs, and marginalized groups—including racial minorities and those in the LGBTQ+ community—experience a disproportionate number of STI cases.9,10 Another important cohort that is vulnerable to STIs are individuals with disabilities.

Significant disparities exist in reproductive healthcare for individuals with disabilities.11., 12., 13., 14. Adolescents with disabilities may experience discrimination surrounding their sexual orientation, sexual behaviors, and sexual health needs.10 Furthermore, there is a higher rate of sexual violence in adolescents with disabilities, with recent data suggesting that this population is 3 times more likely to experience sexual violence than adolescents without disabilities.15., 16., 17 These disparities and stigma contribute to inadequate sexual and reproductive healthcare and may place adolescents and young adults with disabilities at higher risk of STIs. Notably, disparities in healthcare are exacerbated when individuals belong to multiple marginalized groups, as the intersectionality of race, gender, socioeconomic status, and other social identities amplifies barriers to equitable access and treatment.

While current data on prevalence of STIs in individuals with disabilities do exist, most are focused on adults or limit their definition to only include intellectual disabilities.10,18,19 Limited data exists on rates of routine STI testing in adolescents and young adults with all categories of disability. The objective of this observational study was to examine differences in rates of routine STI testing for adolescents and young adults with disabilities compared to those without disabilities.