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Current Inpatient Screening Practices for Sexual History and STIs: An Opportunity to Seize
Gargi Mukherjee1, Chao Zhang1, Swaminathan Kandaswamy1
1Department of Pediatrics, Emory University/Children's Healthcare of Atlanta-Egleston Hospital, Atlanta, GA, USA.
Clinical Pediatrics
|July 10, 2023
Summary
Hospitalizations offer chances for adolescent sexual health screenings. However, sexual history documentation and sexually transmitted infection testing rates remain low in pediatric hospital medicine services, indicating a need for improvement.
Area of Science:
- Pediatric Hospital Medicine
- Adolescent Sexual Health
- Public Health
Background:
- The American Academy of Pediatrics advocates for using hospitalizations to conduct sexual health screenings for adolescents.
- Current practices for sexual history documentation (SHxD) and sexually transmitted infection (STI) testing in hospitalized adolescents are not well-defined.
Purpose of the Study:
- To describe the current practice of SHxD and STI testing among adolescents admitted to a pediatric hospital medicine service.
- To identify factors associated with SHxD and STI screening.
- To determine the prevalence of STIs among tested adolescents.
Main Methods:
- Retrospective cross-sectional study of adolescents (14-19 years) admitted to a pediatric hospital medicine service (2017-2019).
- Data extraction included patient, hospitalization, and physician characteristics.
- A natural language processing algorithm was used to identify SHxD.
- Univariate and multivariable analyses were performed to identify predictors of SHxD and STI screening.
Main Results:
- Of 2242 encounters, SHxD and STI testing rates were 40.9% and 17.2%, respectively.
- Patient gender, race, lack of complex chronic condition, and resident involvement predicted SHxD and STI testing.
- SHxD significantly increased the odds of STI testing (OR 5.06).
- Chlamydia was the most prevalent STI (11.2%) among those tested.
Conclusions:
- Sexual health screening rates are low in the hospital setting for adolescents.
- Future initiatives are needed to improve sexual health screening during hospitalizations.
- SHxD is a significant predictor of STI testing in this population.
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