Hina J. Talib

The Influence of Individual, Partner, and Relationship Factors on HIV Testing in Adolescents

Early identification of HIV by increasing testing is a national priority; however, little is known about HIV testing behaviors in high school age adolescents. We examined the association of individual, partner, and relationship factors with HIV testing using a computer-assisted survey administered from 2003 to 2006 in a community sample of 980 sexually active 14- to 17-year-olds (56% female, 55% Latino, 25% African American) living in a jurisdiction with a high AIDS burden. Twenty percent reported their first sexual encounter as having occurred when they were <13 years of age, 33% had had four or more lifetime sexual partners, 21% reported high partner HIV-risk behavior, and 428 (44%) had been tested for HIV. In our final regression model, independent associations with HIV testing included being female (OR=1.68 [1.23-2.30]), older (OR=1.41 [1.21-1.65]), and having had four or more lifetime sexual partners (OR=2.24 [1.64-3.05]). The strongest independent predictor of HIV testing was having high HIV-related partner communication (OR=3.70 [2.77-4.94]). Being in a serious committed relationship (OR=1.39 [1.02-1.87]) was also independently associated with HIV testing, whereas reporting high worry about HIV/AIDS (OR=0.53 [0.40-0.71]) was independently negatively associated with HIV testing. High HIV/AIDS knowledge, high partner HIV risk behavior, and young age at first sexual encounter were not associated with testing. These findings suggest that, for high school aged adolescents, optimal strategies to promote HIV testing should look beyond increasing HIV/AIDS knowledge and identifying individual risk behaviors to also considering the role of partners and relationships and their influence on testing behavior.

Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum

The degree of exposure to Pediatric and Adolescent Gynecology (PAG) varies across academic programs in Obstetrics and Gynecology, Pediatrics, and Adolescent Medicine. Nevertheless, these programs are responsible to train residents and provide opportunities within their training programs to fulfill PAG learning objectives. To that end, North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG resident education by disseminating the Short Curriculum with specific learning objectives and list of essential resources where key concepts in PAG can be covered.

Long Curriculum in Resident Education.

1 Pediatric and Adolescent Gynecology, Kosair Childrens Hospital, Louisville, Kentucky 2 Pediatric and Adolescent Gynecology, Seattle Childrens Hospital, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington Division of Adolescent Medicine, Childrens Hospital at Memorial University Medical Center, Mercer School of Medicine, Savanah, Georgia Division of Adolescent Medicine, Seattle Childrens Hospital, University of Washington School of Medicine, Seattle, Washington 5 Pediatric and Adolescent Gynecology, Childrens Hospital Colorado, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 7 Section of Adolescent Medicine, Childrens Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado Division of Adolescent Medicine, Childrens Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island 10 Pediatric and Adolescent Gynecology, Childrens Hospital of Eastern Ontario, Department of Obstetrics and Gynecology, University of Ottawa, Canada

Case of a Girl with Chronic Abdominal Pain, Frequent Emergency Room Visits, and Opioid Abuse

A 17-year-old G1P0010 girl was referred to an adolescent medicine specialist by the emergency department (ED) for evaluation of chronic abdominal pain recurring over the past year after she was seen in the ED 2 days ago for cervicitis. She has a history of physical and sexual abuse, extensive psychiatric history, prescription narcotic abuse, gynecologic history of pelvic inflammatory disease, and repeated sexually transmitted infections. Physical exam is significant for multiple tattoos, linear thigh hematoma, diffuse abdominal tenderness to palpation, scant vaginal discharge, and tearfulness on pelvic exam. She seems agitated and uses her cell phone to text throughout the clinic visit. Presentation is concerning for chronic pelvic pain and possible domestic minor sex trafficking (DMST). Because victims of DMST rarely self-identify, it is critical for physicians to recognize the warning signs of sex trafficking and effectively intervene on behalf of these patients to directly affect recovery and outcomes.

Creation and Dissemination of a Multispecialty Graduate Medical Education Curriculum in Pediatric and Adolescent Gynecology: The North American Society for Pediatric and Adolescent Gynecology Resident Education Committee Experiences

STUDY OBJECTIVE The goal was to develop a multispecialty committee to address deficiencies in pediatric and adolescent gynecology (PAG) resident education through curricular development under the auspices of the North American Society for Pediatric and Adolescent Gynecology. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A multispecialty North American committee was organized to develop short as well as long curricula in PAG through a combination of conference calls and face-to-face meetings. Content was guided by objectives of national accrediting organizations. The curricula used print as well as interactive electronic resources. RESULTS After publication of the short and long curricula, a dissemination strategy was developed to present the information at national meetings. A curricular study was performed after introduction of the curriculum to evaluate its efficacy. Long-term plans for further curricular components and expansion of educational tools are ongoing. CONCLUSION We gathered a diverse multispecialty group of doctors to collaborate on a unified educational goal. This committee developed and disseminated resident PAG curricula using a variety of learning tools. This curricular development and implementation can occur with a minimal financial burden.