Prevalence and Trends in the Utilization of Gynecological Services by Adolescent Girls in Germany. Results of the German Health Survey for Children and Adolescents (KiGGS).

There is only limited data available on the utilization of gynecological services in Germany. Based on data from the German Health Survey for Children and Adolescents (KiGGS) of the Robert Koch Institute, a survey carried out across all of Germany, this study aimed to examine the utilization of gynecological services by girls in Germany. Data from the KiGGS Wave 1 survey (2009 - 2012) was used to analyze the factors which affect utilization. The KiGGS baseline study (2003 - 2006) was used to analyze trends. The database consisted of a subsample from the KiGGS Wave 1 survey (n = 2575), the initial follow-up survey conducted by telephone after the baseline study. Data are shown as prevalence and mean with 95% confidence intervals. Correlations with selected influencing factors were calculated using multivariate logistic regression models. Differences between study populations were considered significant if p < 0.05. At the time of the KiGGS Wave 1 survey, 53.9% of girls aged 14 to 17 years had visited a gynecologist at least once. This percentage increased significantly with each additional year of life. For 61.9% of 17-year-old girls who had previously visited a gynecologist at least once, the first visit to a gynecologist occurred at the age of 15 or 16 years. Growing up with siblings was associated with a lower prevalence of utilization, while middle socioeconomic status, risky alcohol consumption and daily consumption of tobacco, and the utilization of general medical services were associated with a higher 12-month prevalence for the utilization of gynecological services. The utilization of gynecological services has increased significantly compared to the KiGGS baseline survey. Among girls there is a high need for information on issues of sexual health. Gynecologists are important but they are not the only port of call. Information needs should be covered as part of a coordinated approach which includes the involvement of all relevant stakeholders. Initiatives such as the WHO Action Plan for Sexual and Reproductive Health and its recommendations should be incorporated.