Background Adolescents with pelvic inflammatory disease [PID] are at risk for recurrent sexually transmitted infections [STI]. There is limited understanding of adolescent responses to notification of subsequent STI. The objective of this study was to examine care-seeking trends after notification.
Methods This study utilised data from 59 of 153 adolescents with PID enrolled in the Technology Enhanced Community Health Nursing [TECH-N] study with positive STI results at 1-month or 3-month study visits. Participants provided vaginal specimens for Neisseria gonorrhoeae [GC], Chlamydia trachomatis [CT],Trichomonas vaginalis [TV], and Mycoplasma genitalium [MG]. Participants were called with results and an outreach worker contacted hard-to-reach participants in the field. Participants were referred for free treatment in a youth-friendly clinic. TECH-N staff tracked treatment using the electronic health record and communication with the health department. Statistical analyses were performed to evaluate responsiveness to notification.
Results Mean age of participants with positive results was 18.1 (2.1) and 44% had a prior STI. At 1-month, positives were 26% CT; 5% GC; 37% TV; 53% MG. At 3 months, positives were 16% CT; 11% GC; 49% TV; 51% MG. All adolescents with positive results were contacted and 50% sought treatment. 60% of CT 0% of GC, 55% of MG, and 57% of TV positives did not seek treatment. 42% who were positive at 1 month remained positive at 3-months. Using GC/CT treatment as a reference, documented treatment rates for positive results were CT/GC (50%) versus MG (54%) at 1 month and TV (60%) and at 3-months were CT/GC (80%) versus MG (55%) and TV (17%). Despite the 3-month trend, differences did not reach statistical significance.
Conclusion Most adolescents who tested positive for STIs after PID were responsive to notification. However, many youth did not seek treatment despite the availability of free, confidential, and youth-friendly sexual health services.
Disclosure of interest statement This study was funded by the National Institute of Nursing Research, Grant # R01NR013507, PI: Trent).