Alpha Omega Alpha Honor Medical Society

2011 Research Abstract

Reproductive Health Experiences and Behaviors Among Adolescent Females with Sickle Cell Disease Compared to Healthy Peers

Investigator: Meera Shah, George Washington University School of Medicine and Health Sciences

Co-investigators: Emily Meier, MD, and Meredith Lynn

Mentor: Lisa Tuchman, MD, MPH, Center for Clinical and Community Research, Children's National Medical Center, Washington, DC

Background: It is not well-understood how reproductive health experiences and behaviors differ among adolescents with and without sickle cell disease (SCD). Objective: The purpose of this study is to compare reproductive health experiences (i.e. menstrual history), and behaviors (i.e. onset of sexual activity, partner characteristics, history of sexually transmitted infections [STI] and contraceptive use) among female adolescents with SCD versus those without.

Design/Methods: Female adolescents aged 13-21 years were recruited from a comprehensive SCD treatment center and a dedicated Adolescent Health Center within an urban academic hospital presenting for routine care. A 10-item survey evaluating reproductive health history including reproductive health experiences and behaviors was administered in the clinical setting.

Results: Thirty-one female adolescents with SCD (mean age 17.3 years ±2.1) and 39 female healthy adolescents (mean age 17.3 years ±2.2) were recruited. Ninety-seven percent (n = 30/31) of participants with SCD and 95% (n = 37/39) of healthy adolescents identified as African-American or black. Menarche occurred earlier among girls without SCD (11.8 yrs vs 12.8 yrs, p=0.02). Thirty-five percent of girls with SCD (n = 11/31) and 62% (n = 24/39) of healthy girls reported having ever had sex. Among those reporting history of sexual intercourse, participants with SCD reported later onset of coitarche when compared with their non-SCD peers (16.8 years vs 14.9 year, p=0.004). A fewer percentage of girls with SCD reported having been treated for an STI compared to girls without SCD (3% vs 28%, p=0.009). Among those that reported being sexually active there were no significant differences in number of sexual partners or contraceptive use among participants with and without SCD.

Conclusions: Female adolescents with SCD had a delayed onset of menarche and coitarche and were less likely to report having had an STI than healthy adolescents. Delayed sexual activity and maturation may have unique psychosocial and disease-specific implications in adolescents with SCD. Further research is needed to address whether older age of sex initiation in adolescents with SCD may be due to delayed pubertal maturation, disease severity, cultural values and/or other psychosocial factors.

Updated on January 10, 2012.

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