School-Based Health Center Access, Reproductive Health Care, and Contraceptive Use Among Sexually Experienced High School Students

Purpose: The current analyses compared receipt of reproductive health care, contraceptive use, and screening for sexually transmitted diseases (STD) among adolescents who are sexually experienced, with or without access to a school clinic. Methods: A total of 12 urban California high schools, selected from areas with high teen pregnancy and STD rates, half with school-based health centers (SBHCs), participated in an intervention study designed to improve sexual health among adolescents. Of the participating students, 44% indicated that they had ever had intercourse and were included in these analyses. Results: Access to an SBHC did not influence receipt of reproductive health care for either males or females and did not influence contraceptive use, either hormonal or condoms, for males. For females, however, those with access to an SBHC had increased odds of having received pregnancy or disease prevention care (adjusted odds ratio [AOR] = 1.45, 95% confidence interval [CI] = 1.16-1.80), having used hormonal contraceptives at last sex (AOR = 1.68, 95% CI = 1.24-2.28), and were more likely to have ever been screened for an STD (AOR = 1.85, 95% CI = 1.43-2.40). Also among female students, those with access to an SBHC were more likely to have used emergency contraception at last sex (AOR = 2.1, 95% CI = 1.08-4.22). Conclusion: Although access to an on-site clinic does not seem to lead to increases in all types of reproductive care in the population as a whole, sexually active females are more likely to have received more specific care and to have used hormonal contraceptives if their school has an SBHC. Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.