STI Testing in Adolescent Males Presenting to an Emergency Department

Abstract

Background: Racial differences in Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) testing and screening are well documented among adolescent females; however, data on adolescent males are limited. We sought to compare racial and ethnic differences in CT/GC testing and screening among adolescent males presenting to a pediatric emergency department (ED).

Methods: Cross-sectional analysis of ED visits made by males aged 13 to 21 years at 2 urban pediatric hospital campuses between January 2021 to February 2023. The primary outcome was performance of CT/GC testing or screening. Multivariable logistic regression assessed racial and ethnic differences in CT/GC testing or screening, adjusting for age and ED site.

Results: Among 17 244 ED visits, 643 (3.7%) included CT/GC testing or screening. Of the 473 (2.7%) visits by symptomatic males, 187 (39.5%) included CT/GC testing. Testing rates were higher in visits by non-Hispanic Black males compared with non-Hispanic white males (50.0% vs 11.8%; adjusted odds ratio [aOR], 3.3 [95% CI, 1.3-8.3]). Of the 16 771 visits by males with non-STI-related chief complaints, 456 (2.7%) included CT/GC screening. Screening rates were higher among visits by non-Hispanic Black males compared with non-Hispanic white males (3.5% vs 0.8%; aOR 3.1 [95% CI, 1.6-5.9]).

Conclusions: There were low rates of CT/GC testing overall; however, visits by non-Hispanic Black adolescent males were more likely to include both testing and screening compared with non-Hispanic white males. More research is needed to determine possible cause of this racial difference and to identify strategies to mitigate potential racial differences in CT/GC testing in the ED.