title: Sexual health behaviors, preferences for care, and use of health services among adolescents in pediatric emergency departments.
abstract: OBJECTIVE
  The objective of this study was to describe sexual health behaviors, as well as prior use of and preferences for sexual health services among adolescents in the pediatric emergency department (ED).
  
  
  METHODS
  In this cross-sectional study, subjects aged 14 to 19 years who presented to an urban or suburban ED from a single Midwestern hospital system completed a written survey. The survey included questions on previous sexual activity, high-risk behaviors (first sex before age 15 years, no condom at last sex, substance use at last sex, >3 partners in past 3 months, and >4 lifetime partners), and sexual health service use and preferences. Comparisons of responses between subgroups were analyzed using χ2 test. Multiple logistic regression was used to identify factors associated with high-risk behaviors. Care preferences were scored using a 4-point Likert scale; mean scores were ranked.
  
  
  RESULTS
  Subjects included 306 adolescents (85% of approached). The mean age was 15.5 years. Almost half (45%) reported previous sexual activity, and of those, 63% reported 1 or more high-risk behaviors (most commonly first sex before age 15 years [43%] and no condom at last sex [29%]). Almost all wanted to prevent pregnancy, but only one third received birth control counseling before sexual debut, and 14% reported no contraception at last sex. Younger age was associated with 1 or more high-risk behaviors (odds ratio, 3.7; confidence interval, 1.39-9.84). Preferences for care included caring, knowledgeable providers, and low/no cost.
  
  
  CONCLUSIONS
  Because of high prevalence of high-risk behaviors among adolescents presenting in the ED, strategies should be developed to link these patients to comprehensive sexual health care.
authors.affiliation: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, MO 64108, USA. mmiller@cmh.edu
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Miller
authors.forename: Michelle
authors.initials: M
authors.lastname: Pickett
authors.forename: Kelsee
authors.initials: K
authors.lastname: Leisner
authors.forename: Ashley K
authors.initials: AK
authors.lastname: Sherman
authors.forename: Sharon G
authors.initials: SG
authors.lastname: Humiston
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D015146:Midwestern United States; D010372:Pediatrics; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult
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