ED Doctors More Likely to Test Teen Girls for Infections

Published on in CHOP News

June 7, 2011 — Teenage girls are almost four times more likely to be tested for sexually transmitted infections (STI) when doctors ask patients with abdominal symptoms about their sexual history during visits to a pediatric emergency department, according to a study by The Children’s Hospital of Philadelphia.

Importance of testing for sexually transmitted infections

The results, published online by the journal Pediatrics, found almost 20 percent of patients who arrived at the emergency department with potential STI-related symptoms did not have a doctor document their sexual history. Increased testing may lead to improved detection of STIs and allow patients to receive earlier treatment, which may help reduce the burden of disease transmission and prevent future problems such as infertility and chronic pain.

Adolescent girls more likely to be affected by STIs

Adolescent females are disproportionately affected by STIs. While teen girls account for only a quarter of the sexually active population, they account for nearly half of all STI diagnoses. Previous studies have shown that when adolescents seek treatment for abdominal pain, they are not always tested for STIs, which may be because healthcare professionals may not be aware the teen is sexually active.

“These findings underscore the importance of performing a sexual history in the emergency department in this high-risk population, as care may be altered based on this information,” said Monika Goyal, MD, study leader and emergency medicine specialist at The Children’s Hospital of Philadelphia.

Teen girls use EDs more often for treatment of STIs

Past studies have shown emergency departments are commonly cited as places teen patients go for treatment of an STI. Often, adolescents do not have a primary care doctor and go to the emergency department for medical care instead.

STIs can easily be confused with other stomach and urinary system ailments. If not identified and treated, STIs can have serious long-term consequences such as infertility, ectopic pregnancy, cervical cancer, as well as chronic disease and death in babies. The presence of an STI also can increase the likelihood of acquiring HIV.

First study to assess how often sexual history is taken when girls arrive at ED

This is the first study to look at how often a sexual history is obtained from teenage girls arriving to the emergency department with STI symptoms and compare that number with the number of girls tested for STIs. The study included 327 females, ages 14 to 19 years, who sought treatment between August 2009 and January 2010 at an urban, pediatric emergency department for lower abdominal and pelvic symptoms.

Future studies should evaluate the doctor’s willingness to assess sexual history in the emergency department patient, the researchers said. Other authors include Cynthia Mollen, MD, MSCE, Marin McCutcheon, BA, and Katie Hayes, BS, all of Children’s Hospital.

More information

"Sexual History Documentation in Adolescent Emergency Department Patients,” Pediatrics published online June 6, 2011, http://pediatrics.aappublications.org/

Read the abstract.