Sexually Transmitted Infection History among Adolescents Presenting to the Emergency Department

Abstract

Background Adolescents and young adults account for about half of annual diagnoses of sexually transmitted infections (STI) in the United States. Screening and treatment for STIs, as well as prevention, is needed in healthcare settings to help offset the costs of untreated STIs. Objective To evaluate the prevalence and correlates of self-reported STI history among adolescents presenting to an ED. Methods Over two and a half years, 4389 youth (ages 14–20) presenting to the ED completed screening measures for a randomized controlled trial. About half (56%) reported lifetime sexual intercourse and were included in analyses examining sexual risk behaviors (e.g., inconsistent condom use), and relationships of STI history with demographics (gender, age, race, school enrollment), reason for ED presentation (i.e., medical or injury), and substance use. Results Among sexually active youth, 10% reported that a medical professional had ever told them they had an STI (212 females, 35 males). Using logistic regression, female gender, older age, Non-Caucasian race, not being enrolled in school, medically-related ED chief complaint, and inconsistent condom use were associated with increased odds of self-reported STI history. Conclusion One in ten sexually active youth in the ED reported a prior diagnosed STI. Previous STI was significantly higher among females than males. ED Providers inquiring about inconsistent condom use and previous STI among male and female adolescents may be one strategy to focus biological testing resources and improve screening for current STI.

Alcohol Use and Sexual Risk Behaviors Among Adolescents With Psychiatric Disorders: A Systematic Review and Meta-Analysis

“…Self-reported STIs were more prevalent in studies that sampled more females and studies that sampled fewer Whites. These findings corroborate prior research showing that females report more STIs and Whites have lower prevalence of STIs compared to non-Whites (Bonar et al, 2015; Bonar et al, 2014). More research is needed to establish the prevalence of STIs in adolescents with a PD and to confirm self-reported rates biologically.…”

“…Finally, studies that sampled younger adolescents (aged ≤14 years) had higher prevalence rates of condom use during the last sex event (66% vs. 33%). Younger adolescents (who are often less sexually experienced) generally report more consistent condom use compared to older adolescents (Bonar et al, 2015). …”

Sexual History Documentation and Sexually Transmitted Infection Screening for Mental Health Patients in a Pediatric Emergency Department

“…14 Female patients are also more likely to report an STI history (possibly because of having received gynecological care in the past). 15 It is possible that, because female patients are often screened for pregnancy in the ED, it is less of a hurdle to obtain a sexual history because they will be tested for pregnancy anyway.…”

Cost-effectiveness of Sexually Transmitted Infection Screening for Adolescents and Young Adults in the Pediatric Emergency Department

“…A literature review of screening in US EDs reported the prevalence of chlamydial and gonococcal infection as ranging between 2.0% and 15.0%, suggesting that those seeking acute care in EDs represent an enriched population with respect to STIs . However, many studies of the prevalence of chlamydia and gonorrhea in the ED population may be biased given that patients who agreed to be enrolled may be self-selected because of concerns about increased risk . In a study of universal screening among asymptomatic adolescents and young adults in an urban ED, 7.9% requested testing because of STI symptoms; the probability of STI among these patients was 25.0% .…”