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. 2015 Feb;31(2):107-12.
doi: 10.1097/PEC.0000000000000284.

Prevalence of 3 sexually transmitted infections in a pediatric emergency department

Melissa K Miller  1 , M Denise Dowd, Christopher J Harrison, Cynthia J Mollen, Rangaraj Selvarangan, Sharon G Humiston
Affiliations

Prevalence of 3 sexually transmitted infections in a pediatric emergency department

Melissa K Miller et al. Pediatr Emerg Care. 2015 Feb.

Abstract

Objective: This study aimed to determine the prevalence of Chlamydia trachomatis, Neisseria gonorrheae, and Trichomonas vaginalis and to describe factors associated with sexually transmitted infection (STI) in a pediatric emergency department (ED).

Methods: Adolescents aged 14 to 19 years presenting to a Midwestern pediatric ED were asked to provide urine for STI testing and complete a survey about previous sexual activity (PSA), high-risk behaviors, demographics, and visit reason (reproductive: genitourinary complaints, abdominal pain, or a female with vomiting). Comparisons between subgroups were analyzed using Χ test.

Results: Among 200 subjects (64% of approached), mean age was 15.6 years; 63% were female. Eleven subjects (6%; 95% confidence interval, 2.3-8.7) tested positive for 1 or more STIs: 10 for C. trachomatis (one denied PSA), 3 for T. vaginalis (all coinfected with C. trachomatis), and 1 for N. gonorrheae. Half reported PSA; of these, 71% reported 1 or more high-risk behaviors, most commonly first sex before the age of 15 years (51%) and no condom at last sex (42%). Among those with PSA and nonreproductive visit (n = 73), 11.0% had 1 or more STIs (95% confidence interval, 3.4-18.1). Two factors were associated with greater likelihood of positive STI test result, namely, reporting PSA versus no PSA (10% vs 1%, P = 0.005) and last sex within 1 month or less versus more than 1 month (20% vs 0%, P = 0.001). In this sample, none of the following characteristics were associated with STI: insurance, race, high-risk behaviors, age, or ED visit reason.

Conclusions: Approximately 1 in 10 sexually active adolescent ED patients without reproductive complaints had 1 or more STIs. This suggests the need for strategies to increase STI testing for this population.

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Conflict of interest statement

The authors have no financial disclosures or conflicts of interest to report.

Figures

Figure 1
Figure 1
Sexually transmitted infection prevalence among subjects by Previous Sexual Activity and Emergency Department visit type
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. [Accessed on April 1, 2013];Sexually Transmitted Diseases. 2011 at http://www.cdc.gov/std/stats11/adol.htm.
    1. Walton MA, Resko S, Whiteside L, Chermack ST, Zimmerman M, Cunningham RM. Sexual Risk Behaviors Among Teens at an Urban Emergency Department: Relationship With Violent Behaviors and Substance Use. J Adol Health. 2011;48:303–305. - PMC - PubMed
    1. Fine LC, Mollen CJ. A Pilot Study to Assess Candidacy for Emergency Contraception and Interest in Sexual Health Education. Pediatr Emerg Care. 2010;26(6):413–416. - PubMed
    1. Mollen CJ, Miller MK, Hayes KL, Barg FK. Knowledge and Beliefs about Emergency Contraception among Adolescents in the Emergency Department. Ped Emerg Care (In Press) - PMC - PubMed
    1. Miller MK, Pickett ML, Leisner KL, Humiston SG. Sexual Health Behaviors and Use of Health Services among Adolescents in an Emergency Department. Ped Emerg Care (In Press) - PMC - PubMed

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