Screening for Asymptomatic Gonorrhea and Chlamydia in the Pediatric Emergency Department
BACKGROUND:
Because
adolescents rely heavily on emergency services for health care, a pediatric
emergency department (PED) visit may be their only opportunity for sexually
transmitted infection (STI) screening. The primary objectives of this study
were to determine the proportion of Neisseria gonorrheae (GC) and Chlamydia
trachomatis (CT) infections in asymptomatic PED adolescents and
patient-perceived barriers to STI screening.
METHODS:
A
convenience sample of patients aged 14 to 21 years presenting to an urban PED
with nongenitourinary complaints was offered screening for GC and CT.
Regardless of declining or accepting screening, all were asked to complete a
questionnaire designed to identify barriers to screening.
RESULTS:
Sixty-eight
percent of those approached participated (n = 719). Those who agreed to STI
screening were more likely to be nonwhite (61.4% vs. 38.6%, P = 0.001) and
publically insured (63.3%) versus privately insured (29.3%) or no insurance
(7.58%). Four hundred three (56%) participants provided urine samples, and of
those, 40 (9.9%) were positive for an STI. Controlling for other demographics,
race was a significant predictor, with the odds of testing positive for
nonwhite participants 5.90 times that of white participants. Patients who
refused testing were more likely to report not engaging in sexual activity
(54.3% vs. 42.4%, P = 0.009) and less likely to perceive that they were at risk
for STIs.
CONCLUSIONS:
There
are high proportions of GC and CT among asymptomatic adolescents visiting an
academic urban PED. A universal PED STI screening program may be an important
component of STI reduction initiatives, especially among adolescents who do not
perceive that they are at risk and may not receive testing elsewhere.
- 1From the*Division of Emergency Medicine, Cincinnati Children's Hospital, Cincinnati, OH; and †Division of Pediatric Emergency Medicine, University of Minnesota Children's Hospital, Minneapolis, MN.
- Sex Transm Dis. 2016 Apr;43(4):209-15. doi: 10.1097/OLQ.0000000000000424.
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