Sexually Transmitted Infection History among Adolescents Presenting to the Emergency Department

J Emerg Med. 2015 Nov;49(5):613-22. doi: 10.1016/j.jemermed.2015.02.017. Epub 2015 May 4.


Background: Adolescents and young adults account for about half of the annual diagnoses of sexually transmitted infections (STI) in the United States. Screening and treatment for STIs, as well as prevention, are needed in health-care settings to help offset the costs of untreated STIs.

Objective: Our aim was to evaluate the prevalence and correlates of self-reported STI history among adolescents presenting to an emergency department (ED).

Methods: Over two and a half years, 4389 youth (aged 14-20 years) 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 (sex, 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 sex, 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.

Conclusions: One in 10 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.

Trial registration: NCT01051141.

Keywords: adolescents; emergency department; risk behaviors; sexually transmitted infections.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Age Factors
  • Coitus
  • Condoms / statistics & numerical data
  • Educational Status
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Prevalence
  • Risk-Taking
  • Sex Factors
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / ethnology
  • United States / epidemiology
  • Unsafe Sex / statistics & numerical data*
  • Young Adult

Associated data