Adolescent Sexually Transmitted Infections: A Community Epidemic

Women under 25 years of age have higher rates of sexually transmitted infections (STIs) than other populations. Providing follow-up for adolescents with an STI is especially challenging in emergency departments (EDs). In our ED, we discovered that a significant number of adolescents with an STI did not receive adequate treatment, and 25% of those with an STI who were treated remained unaware of their infection. These deviations from ideal care are problematic because adolescents with untreated STIs are at risk for pelvic inflammatory disease and infertility. Those who were treated but unaware of their infection are unable to take steps to avoid re-infection, including partner treatment. We hypothesized that an improved system to handle STI test results would reduce the burden on ED staff and increase the proportion of adolescents receiving appropriate follow-up. This intervention has the potential to significantly address the STI epidemic in our community.