Adolescent Sexual Behavior and Emergency Department Use

Weisman, Julie K.; Chase, Alyse; Badolato, Gia M.; Teach, Stephen J.; Trent, Maria; Chamberlain, James M.; Goyal, Monika K.

doi:10.1097/pec.0000000000001456

Cited by 12 publications

(9 citation statements)

References 19 publications

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“…The ED encounter may serve as the only opportunity for clinicians to screen and treat high-risk, often asymptomatic adolescents. 25 Our study demonstrates adolescents’ desire for ED clinicians to engage in sexual health discussions, regardless of why they presented to the ED. The majority of participants not only wanted the clinicians to initiate these discussions, but they also believed the ED is an appropriate setting to respond to these questions.…”

Section: Discussionmentioning

confidence: 65%

Adolescent Attitudes Toward Sexually Transmitted Infection Screening in the Emergency Department

Gearhart¹,

Badolato²,

Goyal³

2018

Pediatr Emer Care

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Objectives Adolescents who seek care in emergency departments (EDs) are often at high risk for sexually transmitted infections (STIs). The objective of this study was to assess adolescent attitudes towards ED-based STI screening. Methods We conducted a secondary analysis of a cross-sectional study that evaluated STI screening acceptability and prevalence when STI testing was universally offered to asymptomatic adolescents presenting to the ED for care. Adolescents 14–21 years old completed a computerized survey and answered questions regarding attitudes towards ED-based STI screening and sexual behavior. We performed multivariable logistic regression to compare differences in attitudes towards ED-based STI screening among patients who agreed versus declined STI testing. Results 326 of 553 (59.0%) adolescents agreed to be tested for STIs. The majority (72.1%) believed the ED was an appropriate place for STI screening. Patients who agreed to be tested for STIs were more likely to positively endorse ED-based STI screening than those who declined STI testing (77.0% vs 64.8%%; aOR 1.6, [95% CI 1.1, 2.4]). Most (82.6%) patients stated they would feel comfortable getting tested for STI’s in the ED. There was no difference in comfort level of ED-based STI testing between those who agreed and declined STI testing (83.5% vs 81.4% aOR 1.1, [95% CI 0.7, 1.8]). Conclusion Our results suggest that adolescents view the ED as an acceptable location for STI screening. Therefore the ED may serve a role in increasing the accessibility of STI detection and prevention resources for adolescents.

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Section: Discussionmentioning

confidence: 65%

Adolescent Attitudes Toward Sexually Transmitted Infection Screening in the Emergency Department

Gearhart¹,

Badolato²,

Goyal³

2018

Pediatr Emer Care

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“…Young adults make up the majority of STI cases and are known to frequent the ED for healthcare [1,17,20]. These cases represent a sizeable number of patients with CT that could go undiagnosed without self-administered screening in the ED.…”

Section: Plos Onementioning

confidence: 99%

Association between Chlamydia and routine place for healthcare in the United States: NHANES 1999–2016

et al. 2021

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Background The United States is experiencing a surge in Chlamydia trachomatis (CT) infections representing a critical need to improve sexually transmitted infection (STI) screening and treatment programs. To understand where patients with STIs seek healthcare, we evaluated the relationship between CT infections and the place where individuals report usually receiving healthcare. Methods Our study used a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. The study population is adult patients, aged 18 to 39 years in whom a urine CT screen was obtained. Logistic regression models were used to determine if location of usual healthcare was predictive of a positive urine CT screen result. Models were adjusted for known confounders including age, gender, race/ethnicity, education, and insurance status. Results In this nationally representative sample (n = 19,275; weighted n = 85.8 million), 1.9% of individuals had a positive urine CT result. Participants reported usually going to the doctor’s office (70.3%), “no place” (24.8%), Emergency Department (ED) (3.3%), or “other” place (1.7%) for healthcare. In adjusted models, the predicted probability of having a positive urine CT result is higher (4.9% vs 3.2%, p = 0.022; OR = 1.58) among those that reported the ED as their usual place for healthcare compared to those that reported going to a doctor’s office or clinic. Conclusions Individuals having a positive urine CT screen are associated with using the ED as a usual source for healthcare. Understanding this association has the potential to improve STI clinical and policy interventions as the ED may be a critical site in combatting the record high rates of STIs.

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“…On the other hand, coherently with other studies, EDs in addition, even if less well-equipped for STIs, are frequently selected as suitable venues for STIs’ care [ 21 ]. This could happen because citizens are unaware of characteristic symptoms or the availability of STI specialized services, or they may inappropriately prefer the ED as a direct access point, especially in situations of perceived urgency, as EDs have no time restrictions and may be closer to the patient’s home [ 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Ten-Year Trend in Emergency Department Visits for Sexually Transmitted Infections among Adolescents: A Retrospective Cross-Sectional Study in Italy

Viottini¹,

Albanesi²,

Casabona³

et al. 2022

IJERPH

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Sexually transmitted infections (STIs) are frequently underdiagnosed, representing a serious public health concern, especially during adolescence and in more vulnerable communities. Aim: to describe the last ten years of emergency department (ED) visits for STIs among adolescents. Methods: a retrospective cross-sectional observation was carried out in the Piedmont region in Italy. Data were retrieved through the Italian National Information System database. ED visits related to specific ICD-9-CM codes carried out on 11 to 19-year-old youths between 2011 and 2020 were investigated. Age-specific, crude, and standardized rates and admission ratios, with 95% confidence intervals (CIs), were calculated to estimate the STI trend. Results: from a total of 1,219,075 ED visits, 339 were related to STIs, representing an increasing ratio of 28 per 100,000 visits, primarily in females. Most infections occurred in girls (83.5%) and among 17 to 19-year-olds (71.5%). A drop in both ED visits and STI cases was observed in 2020. Genital Herpes and Genital Warts were more frequent in girls while Gonorrhea was more frequent in boys. Conclusions: the increasing trend of ED visits for STIs, particularly in girls, represents an emerging relevant public health issue that needs to be urgently tackled.

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Adolescent Sexual Behavior and Emergency Department Use

Cited by 12 publications

References 19 publications

Adolescent Attitudes Toward Sexually Transmitted Infection Screening in the Emergency Department

Adolescent Attitudes Toward Sexually Transmitted Infection Screening in the Emergency Department

Association between Chlamydia and routine place for healthcare in the United States: NHANES 1999–2016

Ten-Year Trend in Emergency Department Visits for Sexually Transmitted Infections among Adolescents: A Retrospective Cross-Sectional Study in Italy

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