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.