Sexually Transmitted Infection Testing in Adolescents: Current Practices in the Hospital Setting

Abbey R. Masonbrink, Troy Richardson, Russell J. McCulloh, Matt Hall, Jessica L. Bettenhausen, Jacqueline M. Walker, Matthew B. Johnson, Mary Ann Queen, Jessica L. Markham, Monika K. Goyal

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Abstract

Purpose: Adolescents are disproportionately affected by sexually transmitted infections (STIs), and evidence supports expanding sexual health services to the hospital setting. Because STI testing practices in the hospital setting are poorly understood, we sought to describe current STI testing practices among adolescents seen in children's hospitals. Methods: We performed a retrospective analysis of adolescents (14–18 years old) from 45 children's hospitals in 2015–2016, excluding visits with a billing code for sexual abuse/assault. We calculated rates of STI testing and investigated differences in STI testing by patient and hospital characteristics using generalized linear mixed modeling. Results: Of the 541,714 adolescent encounters, 59,158 (10.9%) underwent STI testing. After adjusting for demographic characteristics, those with an STI test were more likely to be female (adjusted odds ratio [aOR] 1.61; 95% confidence interval [CI] 1.58–1.64), of non-Hispanic black race/ethnicity (aOR 1.20; 95% CI 1.17–1.23), or from the lowest median household income quartile (aOR 1.21; 95% CI 1.17–1.24). There was substantial inter-hospital variation in adjusted rates of STI testing (3%–24%), but strong correlation was observed between STI testing rates in the ED and inpatient settings within individual hospitals (adjusted R2.99). Conclusions: Only one in ten adolescents seen in children's hospitals underwent STI testing with wide variation in testing patterns across hospitals. There are critical opportunities to increase adolescent STI testing in this setting. Our findings highlight potential disparities in STI testing rates and patterns that warrant further exploration from the patient, provider, and health system perspective.

Original languageEnglish (US)
Pages (from-to)342-347
Number of pages6
JournalJournal of Adolescent Health
Volume63
Issue number3
DOIs
StatePublished - Sep 2018

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Keywords

  • Emergency department
  • Inpatient
  • Sexual and reproductive health

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

Masonbrink, A. R., Richardson, T., McCulloh, R. J., Hall, M., Bettenhausen, J. L., Walker, J. M., Johnson, M. B., Queen, M. A., Markham, J. L., & Goyal, M. K. (2018). Sexually Transmitted Infection Testing in Adolescents: Current Practices in the Hospital Setting. Journal of Adolescent Health, 63(3), 342-347. https://doi.org/10.1016/j.jadohealth.2018.04.013