title: Dating aggression and risk behaviors among teenage girls seeking gynecologic care.
abstract: OBJECTIVE
  The objective was to describe rates of dating aggression and related high-risk behavior among teens presenting to the emergency department (ED) seeking gynecologic care, compared to those seeking care for other reasons.
  
  
  METHODS
  Female patients ages 14-18 years presenting to the ED during the afternoon/evening shift of a large urban teaching hospital over a 19-month period were approached to participate and completed a self-administered computerized survey regarding sexual risk behaviors, past-year alcohol use, dating aggression, and peer aggression. Logistic regression analysis was used to identify factors associated with the evaluation of gynecologic complaint as noted by completion of a pelvic exam.
  
  
  RESULTS
  A total of 949 teens were enrolled (87% response rate), with 148 receiving gynecologic evaluation. Among girls undergoing a gynecologic evaluation, 49% reported past-year dating aggression, compared to 34% of those who did not undergo gynecologic evaluation (odds ratio [OR] = 1.81, 95% confidence interval [CI] = 1.30 to 2.62). Logistic regression analysis predicting gynecologic evaluation found statistically significant variables to be older age (OR = 1.95, 95% CI = 1.24 to 3.06), African American race (OR = 1.58, 95% CI = 1.04 to 2.40), parental public assistance (OR = 1.64, 95% CI = 1.10 to 2.45), alcohol use (OR = 2.31, 95% CI = 1.57 to 3.38), and dating aggression (OR = 1.51, 95% CI = 1.03 to 2.21).
  
  
  CONCLUSIONS
  Of the teens undergoing gynecologic evaluation in this urban ED, 49% reported dating aggression. These teens also reported higher rates of other sexual risk behaviors compared to their peers. Care providers in urban EDs treating all female teens and particularly those seeking gynecologic care should be aware of this high rate of dating aggression and screen for aggression in dating relationships in this high-risk group.
authors.affiliation: Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA. laurenwh@med.umich.edu
authors.forename: Lauren K
authors.initials: LK
authors.lastname: Whiteside
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Walton
authors.forename: Rachel
authors.initials: R
authors.lastname: Stanley
authors.forename: Stella M
authors.initials: SM
authors.lastname: Resko
authors.forename: Steve T
authors.initials: ST
authors.lastname: Chermack
authors.forename: Marc A
authors.initials: MA
authors.lastname: Zimmerman
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D000374:Aggression; D000428:Alcohol Drinking / Q000453:epidemiology; D016009:Chi-Square Distribution; D003380:Courtship; D004636:Emergency Service, Hospital; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis; D006801:Humans; D016015:Logistic Models; D008824:Michigan / Q000453:epidemiology; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires