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Adolescent assault victims often do not receive STI testing, prophylaxis

Large disparities were seen among pediatric EDs for STI and pregnancy testing and prophylaxis in adolescent victims of sexual assault, according to recently published data.

“In this large, multicenter study of adolescents evaluated in pediatric EDs for sexual assault, we found substantial variation in rates of performance of recommended testing and prophylaxis across hospitals,” the researchers wrote.

The researchers analyzed data from the Pediatric Hospital Information System database to assess rates of testing and prophylaxis for chlamydia, gonorrhea and pregnancy among adolescents presenting to a pediatric ED for sexual assault. The analysis included 12,687 cases of sexual assault among patients aged 12 to 18 years across 38 pediatric EDs.

Results demonstrated that recommended testing was receiving by 44% of patients and recommended prophylaxis was received by 35% of patients.

Disparities in testing and prophylaxis were seen across EDs, ranging from 6% to 89% and 0% to 57%, respectively. Specifically, pregnancy testing varied widely across hospitals, ranging from 15% to 95%, and emergency contraception ranged from 0% to 65%.

Patients presenting to EDs that had developed clinical pathways for caring for sexual assault victims were almost 50% more likely to receive prophylaxis (OR = 1.46; 95% CI, 1.15-1.86), according to the researchers.

No association was seen between prophylaxis and specialized teams within the ED.

The researchers noted that these findings point to the need for guidelines and standards of care for adolescent sexual assault patients across EDs.

“Our findings suggest that sexual assault pathways show promise in improving adherence to recommended treatments for this population, but further research is needed to better understand the role of pathways in improving quality of care,” the researchers concluded. – by Casey Hower

Disclosures: The researchers report no relevant financial disclosures.