• Melissa K Miller, M Denise Dowd, Christopher J Harrison, Cynthia J Mollen, Rangaraj Selvarangan, and Sharon G Humiston.
• From the Divisions of *Emergency and Urgent Care and †Infectious Disease, Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, MO; ‡Division of Emergency Medicine, Children's Hospital of Philadelphia; and Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; and §Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals and Clinics, Kansas City, MO.
• Pediatr Emerg Care. 2015 Feb 1; 31 (2): 107112107-12.

ObjectiveThis study aimed to determine the prevalence of Chlamydia trachomatis, Neisseria gonorrheae, and Trichomonas vaginalis and to describe factors associated with sexually transmitted infection (STI) in a pediatric emergency department (ED).MethodsAdolescents aged 14 to 19 years presenting to a Midwestern pediatric ED were asked to provide urine for STI testing and complete a survey about previous sexual activity (PSA), high-risk behaviors, demographics, and visit reason (reproductive: genitourinary complaints, abdominal pain, or a female with vomiting). Comparisons between subgroups were analyzed using Χ test.ResultsAmong 200 subjects (64% of approached), mean age was 15.6 years; 63% were female. Eleven subjects (6%; 95% confidence interval, 2.3-8.7) tested positive for 1 or more STIs: 10 for C. trachomatis (one denied PSA), 3 for T. vaginalis (all coinfected with C. trachomatis), and 1 for N. gonorrheae. Half reported PSA; of these, 71% reported 1 or more high-risk behaviors, most commonly first sex before the age of 15 years (51%) and no condom at last sex (42%). Among those with PSA and nonreproductive visit (n = 73), 11.0% had 1 or more STIs (95% confidence interval, 3.4-18.1). Two factors were associated with greater likelihood of positive STI test result, namely, reporting PSA versus no PSA (10% vs 1%, P = 0.005) and last sex within 1 month or less versus more than 1 month (20% vs 0%, P = 0.001). In this sample, none of the following characteristics were associated with STI: insurance, race, high-risk behaviors, age, or ED visit reason.ConclusionsApproximately 1 in 10 sexually active adolescent ED patients without reproductive complaints had 1 or more STIs. This suggests the need for strategies to increase STI testing for this population.

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