Sexually Transmitted Infection History among Adolescents Presenting to the Emergency Department
BACKGROUND:
Adolescents
and young adults account for about half of the annual diagnoses of sexually
transmitted infections (STI) in the United States. Screening and treatment for
STIs, as well as prevention, are needed in health-care settings to help offset
the costs of untreated STIs.
OBJECTIVE:
Our
aim was to evaluate the prevalence and correlates of self-reported STI history
among adolescents presenting to an emergency department (ED).
METHODS:
Over two
and a half years, 4389 youth (aged 14-20 years) 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 (sex, 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
sex, 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.
CONCLUSIONS:
One
in 10 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.
- 1Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, Michigan.
- 2Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, Michigan; Injury Center, University of Michigan, Ann Arbor, Michigan.
- 3Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan; Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan.
- 4Division of Emergency Medicine, University of Washington, Seattle, Washington.
- 5Department of Veterans Affairs National Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan; Department of Psychiatry, Mental Health Services Outcomes and Translation Section, University of Michigan, Ann Arbor, Michigan.
- 6Injury Center, University of Michigan, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan; School of Public Health, University of Michigan, Ann Arbor, Michigan.
- J Emerg Med. 2015 Nov;49(5):613-22. doi: 10.1016/j.jemermed.2015.02.017. Epub 2015 May 4.
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