HIV and Syphilis Screening Among Adolescents Diagnosed With Pelvic Inflammatory Disease

Women with pelvic inflammatory disease (PID) are at an increased risk for syphilis and HIV, but screening rates among adolescents have been understudied. Our objective is to measure the frequency of HIV and syphilis screening among adolescents who are diagnosed with PID and identify patient- and hospital-level characteristics associated with screening.

We performed a retrospective cohort study using the Pediatric Health Information System from 2010 to 2015. We included visits to the emergency department by female adolescents who were diagnosed with PID and determined the frequency of HIV and syphilis screening. We performed separate multivariable logistic regression analyses to identify factors associated with screening.

Of the 10 698 patients who were diagnosed with PID, 22.0% (95% confidence interval [CI] 21.2%-22.8%) underwent HIV screening, and 27.7% (95% CI 26.9%-28.6%) underwent syphilis screening. Screening rates varied by hospital (HIV: 2.6%-60.4%; syphilis: 2.9%-62.2%). HIV screening was more likely to occur in younger (adjusted odds ratio [aOR] 1.2; 95% CI 1.0-1.3), non-Hispanic African American (aOR 1.4; 95% CI 1.2-1.7), non-privately insured (publicly insured [aOR 1.3; 95% CI 1.1-1.5], uninsured [aOR 1.6; 95% CI 1.2-2.0]), and admitted patients (aOR 7.0; 95% CI 5.1-9.4) at smaller hospitals (aOR 1.4; 95% CI 1.0-1.8). Syphilis screening was more likely to occur in younger (aOR 1.1; 95% CI 1.0-1.3), non-Hispanic African American (aOR 1.8; 95% CI 1.2-2.8), non-privately insured (publicly insured [aOR 1.4; 95% CI 1.2-1.6], uninsured [aOR 1.6; 95% CI 1.2-1.9]), and admitted patients (aOR 4.6; 95% CI 3.3-6.4).

We found low rates of HIV and syphilis screening among adolescents who were diagnosed with PID, with wide variability across hospitals.