Adolescent Attitudes Toward Sexually Transmitted Infection Screening in the Emergency Department

Gearhart, Addison; Badolato, Gia M.; Goyal, Monika K.

doi:10.1097/pec.0000000000001387

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…Moreover, urine chlamydia/gonorrhea testing can easily be collected with the urine pregnancy test. Studies have found that adolescents consider the ED an acceptable site for STI screening [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department

Vayngortin

Clark

Hollenbach

2022

IJERPH

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Adolescents with mental illness often seek care in the emergency department (ED) and are more likely to engage in risky behaviors such as substance abuse and unprotected sex, increasing their risk of sexually transmitted infections (STI), unintended pregnancy, and non-consensual sex. This was a retrospective study of 312 females, aged 13–17 years, presenting to the pediatric ED with the chief complaint of suicidal ideation from February to May 2018. Electronic medical records were reviewed for demographics, psychiatric history, sexual history, and testing for pregnancy or STI. The primary outcome was the documentation of the presence or absence of prior sexual activity. Secondary outcomes included documented aspects of sexual history and pregnancy or STI testing performed in the ED. Of the 312 eligible patients, 144 (46.2%) had a documented sexual history, and of those 50 (34.7%) reported being sexually active. Sexual history documentation was not associated with patient age, race, ethnicity, insurance, or the gender of the ED provider. A history of anxiety and a recent suicide attempt were associated with a lack of sexual history documentation (p = 0.03). Of the sexually active patients, 28 (56%) had documentation of contraception use. Pregnancy testing was performed in 67.3% of all patients and 80% of sexually active patients. Only 10 patients had STI testing in the ED, with most testing occurring in those with sexual history documentation (p = 0.007). In conclusion, more than half of females with suicidal ideation in our ED had no documentation of sexual history, and when documentation was completed, it was often missing important elements, including screening for pregnancy, STI, non-consensual sex, and contraception use. Since the ED visit provides an important opportunity to address the reproductive health needs of this high-risk population, further work is needed to determine ways to improve provider documentation and sexual health screening.

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Section: Discussionmentioning

confidence: 99%

Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department

Vayngortin

Clark

Hollenbach

2022

IJERPH

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“…Research has demonstrated that most adolescents feel that the PED is an appropriate place to be asked about sexual history, regardless of their presenting chief complaint. 16,17 Studies have also shown that obtaining a sexual history increases the frequency of STI testing. 17 Of the patients for whom a history was taken, more than half (59.2%) were sexually active, indicating a definite need for screening in this population.…”

Section: Discussionmentioning

confidence: 99%

“…Although many aspects of STI testing/screening can be difficult to control (patients may not consent, for example), getting a sexual history is a controllable aspect of the treating physician's role. Research has demonstrated that most adolescents feel that the PED is an appropriate place to be asked about sexual history, regardless of their presenting chief complaint 16,17 . Studies have also shown that obtaining a sexual history increases the frequency of STI testing 17 …”

Section: Discussionmentioning

confidence: 99%

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

Ekström

Alfath²,

Schneider

2022

Pediatr Emer Care

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Objectives: Adolescents with psychiatric conditions more commonly engage in high-risk sexual behaviors and are at increased risk of sexually transmitted infections (STIs) and when presenting to pediatric emergency departments (PEDs) may be an important population in which to target screening efforts. This study aimed to determine frequency of physiciandocumented sexual history and STI screening in adolescents presenting to a PED with mental health-related complaints.Methods: Retrospective study of patients aged 14 to 18 years presenting to a PED February 2015 to September 2016. Electronic records were reviewed for demographics, chief complaint, sexual history documentation, STI screening, resident involvement in patient care, and disposition. Proportions were calculated for frequencies, whereas χ 2 and Fisher exact tests evaluated factors associated with documentation of sexual history and STI screening.Results: Two hundred eighty-five patient encounters were identified.Age range was 15 to 18 years with an average of 16 years, and 58% were girls. The most common chief complaint was "intentional ingestion/ overdose" (169 encounters, 59%) followed by "suicidal/attempted suicide" (59, 21%). Seventy-seven patients (27%) had sexual history documented. Girls were more likely to have sexual history documented (75% vs 52%, P = 0.0004). Forty-five (59%) patients were noted to be sexually active, and 17 (38%) of these were screened for STI. There was no relationship between screening and race, sex, or involvement of a resident in patient care. Conclusions:In a high-risk PED population, physicians documented sexual history only 27% of the time. Female patients were more likely to have a sexual history documented. In patients with sexual history indicating risk for STI, less than half were screened.

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Sexually transmitted infection testing and diagnosis in adolescents and young adults with sickle cell disease

Walden,

Stanek,

Ebersole

et al. 2024

Pediatric Blood & Cancer

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BackgroundSexually transmitted infections (STIs) are common and disproportionately affect Black adolescents and young adults (AYAs). Less is known about STIs among Black AYAs with chronic conditions, such as sickle cell disease (AYAs‐SCD). This study compared STI testing and diagnosis between AYAs‐SCD and their peers, overall and among STI‐related encounters.ProcedureThis retrospective, cross‐sectional study used diagnosis and billing codes in the Pediatric Health Information System (PHIS) to identify inpatient and emergency department encounters from January 1, 2022 to May 31, 2023 among all AYAs 15–24 years and those with STI‐related diagnoses (e.g., “cystitis”). STI testing and diagnosis rates were compared between AYAs‐SCD, non‐Black AYAs, and Black AYAs, controlling for age, sex, and encounter setting.ResultsWe identified 3602 AYAs‐SCD, 177,783 Black AYAs, and 534,495 non‐Black AYAs. AYAs‐SCD were less likely to be tested for STIs than non‐Black AYAs (odds ratio [OR] = 0.26; adj. p < .001) and Black AYAs (OR = 0.53; adj. p < .001). When tested, AYAs‐SCD were more likely to be diagnosed with an STI than non‐Black AYAs (OR = 2.39; adj. p = .006) and as likely as Black AYAs (OR = 0.67; adj. p = .15). Among STI‐related encounters, AYAs‐SCD were less likely to be tested than non‐Black AYAs (OR = 0.18; adj. p < .001) and Black AYAs (OR = 0.44; adj. p < .001). No significant differences in STI diagnoses were found in this subset between AYAs‐SCD and non‐Black AYAs (OR = 0.32; adj. p = .28) or Black AYAs (OR = 1.07; adj. p = .99).ConclusionsSTI care gaps may disproportionately affect AYAs‐SCD. STIs should be considered when evaluating symptomatic AYAs‐SCD in acute settings. More research is needed to further contextualize STI care for AYAs‐SCD.

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Adolescent Attitudes Toward Sexually Transmitted Infection Screening in the Emergency Department

Cited by 6 publications

References 23 publications

Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department

Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department

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

Sexually transmitted infection testing and diagnosis in adolescents and young adults with sickle cell disease

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