Citation

Gessner BD. Obstet. Gynecol. 2006; 108(1): 111-118.

Affiliation

Alaska Division of Public Health, Anchorage, Alaska 99524, USA. Brad_Gessner@health.state.ak.us

Erratum On

Obstet Gynecol 2006;108(4):1035.

Copyright

(Copyright © 2006, Lippincott Williams & Wilkins)

DOI

10.1097/01.AOG.0000223873.03115.c9

PMID

16816064

Abstract

OBJECTIVE: To quantify the degree of abuse or criminal behavior among young females presenting for reproductive health care services. METHODS: An evaluation was conducted among Alaskan females age 10 through 15 years enrolled in Medicaid. Subjects were identified who had experienced reproductive health outcomes. The Medicaid file was linked to a Child Protective Services database and a Juvenile Justice database to identify episodes of abuse by a caretaker and criminal behavior. RESULTS: Of 21,350 Alaskan females aged 10-15 years enrolled in Medicaid during 1999-2003, 841 (3.9%) presented for reproductive health care, 2,930 (14%) were referred to Child Protective Services and 1,858 (8.7%) were referred to Juvenile Justice for criminal activity. Among the subjects with a reproductive health-related claim, 39% were referred to Child Protective Services while 31% were referred to Juvenile Justice at some point during the study period. Reproductive health care was strongly associated with referral to Child Protective Services (adjusted odds ratio aOR 2.9, 95% confidence interval CI 2.5-3.4), substantiated sexual abuse (aOR 2.3, 95% CI 1.7-3.2), and referral to Juvenile Justice (aOR 2.9, 95% CI 2.5-3.4). These associations remained regardless of the type of reproductive health care, including contraceptive management. CONCLUSION: Females aged 10-15 years enrolled in Medicaid who present for any type of reproductive health care are at increased risk of abuse by a caretaker and criminal behavior. Clinicians caring for low-income females should consider routine screening for sexual activity and the experience of violence. LEVEL OF EVIDENCE: II-2.

Language: en