title: Health-seeking behaviors and sexually transmitted diseases among adolescents attending an urban pediatric emergency department.
abstract: BACKGROUND
  Adolescents are often seen in Emergency departments (ED) for urgent care. Rates of treatable sexually transmitted diseases (Neisseria gonorrhoeae and Chlamydia trachomatis) are highest in this age group. This study examines the prevalence of these sexually transmitted diseases (STDs) and the health seeking characteristics of adolescents presenting to an urban pediatric ED.
  
  
  METHODS
  Participants were enrolled between January 2000 and July 2004. Urine specimens (tested for the STDs) and a questionnaire data form (demographics and health seeking behaviors) were collected and scanned into a computer database, and results were merged for analysis. Prevalence rates were calculated for gonorrheal and chlamydial infections.
  
  
  RESULTS
  A total of 1,621 participants were enrolled. Prevalence rates for C. trachomatis and N. gonorrhoeae were 9.8% (95% CI 8.6, 11.1) and 3.4% (95% CI 2.6,4.2), respectively. Test results did not differ significantly by race (p= 0.29). Reporting of a regular health care provider vs no regular provider did not significantly impact the likelihood of having a positive test result, 10.7% (95% CI 9.1, 12.4) vs 12.1% (95% CI 5.4, 18.8) (p=0.69). The prevalence of STDs was higher among uninsured (16.3, 95% CI 12.3, 20.3) and those participants covered by Medicaid (13.3, 95% CI 10.6, 16.1) compared to those reporting private insurance (6.0, 95% CI 4.2, 7.7).
  
  
  CONCLUSIONS
  This study confirms a high prevalence of treatable STDs among adolescents in an urban ED setting and provides information on frequency of ED usage and health-seeking behaviors among adolescents.
authors.affiliation: University of Alabama, Birmingham, AL, USA. kmonroe@peds.uab.edu
authors.forename: Kathy W
authors.initials: KW
authors.lastname: Monroe
authors.forename: Marga
authors.initials: M
authors.lastname: Jones
authors.forename: Renee
authors.initials: R
authors.lastname: Desmond
authors.forename: Edward W
authors.initials: EW
authors.lastname: Hook
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D001741:Black or African American / Q000706:statistics & numerical data; D000407:Alabama / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology*; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D015995:Prevalence; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data