title: Sexually Transmitted Infection History among Adolescents Presenting to the Emergency Department.
abstract: BACKGROUND
  Adolescents and young adults account for about half of the annual diagnoses of sexually transmitted infections (STI) in the United States. Screening and treatment for STIs, as well as prevention, are needed in health-care settings to help offset the costs of untreated STIs.
  
  
  OBJECTIVE
  Our aim was to evaluate the prevalence and correlates of self-reported STI history among adolescents presenting to an emergency department (ED).
  
  
  METHODS
  Over two and a half years, 4389 youth (aged 14-20 years) presenting to the ED completed screening measures for a randomized controlled trial. About half (56%) reported lifetime sexual intercourse and were included in analyses examining sexual risk behaviors (e.g., inconsistent condom use), and relationships of STI history with demographics (sex, age, race, school enrollment), reason for ED presentation (i.e., medical or injury), and substance use.
  
  
  RESULTS
  Among sexually active youth, 10% reported that a medical professional had ever told them they had an STI (212 females, 35 males). Using logistic regression, female sex, older age, non-Caucasian race, not being enrolled in school, medically related ED chief complaint, and inconsistent condom use were associated with increased odds of self-reported STI history.
  
  
  CONCLUSIONS
  One in 10 sexually active youth in the ED reported a prior diagnosed STI. Previous STI was significantly higher among females than males. ED providers inquiring about inconsistent condom use and previous STI among male and female adolescents may be one strategy to focus biological testing resources and improve screening for current STI.
authors.affiliation: Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Bonar
authors.affiliation: Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, Michigan; Injury Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Walton
authors.affiliation: Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan; Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan.
authors.forename: Martina T
authors.initials: MT
authors.lastname: Caldwell
authors.affiliation: Division of Emergency Medicine, University of Washington, Seattle, Washington.
authors.forename: Lauren K
authors.initials: LK
authors.lastname: Whiteside
authors.affiliation: Department of Veterans Affairs National Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan; Department of Psychiatry, Mental Health Services Outcomes and Translation Section, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Barry
authors.affiliation: Injury Center, University of Michigan, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan; School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D000367:Age Factors; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012737:Sex Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: adolescents; emergency department; risk behaviors; sexually transmitted infections