Introduction Sexually Transmitted Infections (STIs) remain prevalent in urban populations and are often diagnosed in emergency departments (ED). However, the burden of STI-care on urban EDs is not well characterised.
Methods We conducted a retrospective study of patients seeking acute care for STI-related complaints at a large urban academic ED in the Midwestern US from July, 2012 to June, 2014. All ED patients evaluated for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (Ct) infection by nucleic acid amplification testing were examined for demographic characteristics, testing rates, and STI prevalence.
Results Approximately 183,000 ED patient visits occurred during the study period. Of these, 6,518 visits (3.6%) resulted in STI testing for 5,431 patients. For tested patients, 77% were female, 83% African-American, and median age was 26.3(IQR 22.1–34.5). Overall prevalence was 6.8% for GC and 11.8% for Ct among patients tested. Among patients positive for GC, Ct, or both, 55.04–74.5% were female and 60.5–72.2% were ≤24 years. A total of 758 patients (14%) were tested more than once in the ED during the study period and defined as “super-users”. These super-users made up 28% of the total visits during the study period. Super-users were more likely to be female, African American and older adolescents (age 20–24) (p < 0.001). Super-users were more likely than non-super-users to have a positive test for GC (p < 0.001) and Ct (p < 0.001)], and had GC prevalence more than twice that of non-super-users (13.1% vs 5.7%, p < 0.001).
Conclusion Our study revealed a significant burden of STI-related diagnoses, especially GC, in the urban ED setting. ED super-users were more likely to have a positive test than those tested patients only once, and may represent a higher risk population. Additional research is needed to understand the unique patient population presenting to urban EDs for STI care and inform tailored intervention strategies.
Disclosure of interest All authors report no disclosures.
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