Acceptability of Screening for Sexually Transmitted Infections in an Urban Pediatric Emergency Department in the Southern Region of the United States

BACKGROUND: Adolescents age 13 to 24 years old are the demographic most affected by sexually transmitted infections (STIs) in the USA. The CDC, USPSTF and the AAP recommend screening sexually active females less than 25 years old in all health care settings for Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT) and all high-risk females of this age group also for HIV and Syphilis. In regions with a high prevalence of STIs, such as Dallas County, the diagnosis and treatment of STIs is a vital step toward reducing the spread of these communicable diseases in this population. METHODS: All adolescents age 13-24 presenting to the Pediatric Emergency Department (PED) during the study period who met the study criteria were asked to participate. A total of 197 adolescents and 198 parents, 183 of which comprised parent-child dyads, were enrolled and completed separate surveys. Participants answered questions about adolescent and parent acceptability of STI screening, STI risk behaviors, and adolescents' history of STI screening and treatment. RESULTS: Analysis thus far shows that non-invasive STI screening is acceptable to the majority of both adolescents (70%) and parents (84%). Among patient/parent dyads, 59% had positive responses from both. No demographic factors demonstrated statistical significance. However, some factors displayed greater variability than others. In terms of age, adolescents greater than 15 years old were more likely to indicate acceptance of STI testing (73%) than those younger than age 15 (62%). Breakdown by adolescent race and ethnicity demonstrated a range of acceptability with 83% for those who identified as White or Caucasian, 59% for those identifying as Black or African American, 64% for those identifying as Hispanic, and 100% of the five participants identifying outside of the previous categories, "other". CONCLUSIONS: These acceptability results are similar to those found in a study performed in Jefferson County, AL where adolescents reported a 71% acceptance rate for GC and CT screening. This suggests that implementation of STI screening in the PED would be successful and well tolerated by the majority of adolescents and their parents. The variation in acceptability demonstrated by age and race were not statistically significant but may be useful in determining the minimum age of PED intervention and preparing culturally sensitive answers for questions from adolescents and patients in future testing interventions. Implementation of new PED HIV screening protocols are utilizing evidence based on this study and will further be assessed for continued improvement of Dallas adolescent health.