PC1032: Does Culture Affect Who We Culture?

Background: Sexually transmitted infection (STI) rates among adolescents presenting to pediatric emergency departments (PED) are as high as 10-20%. Previous literature has suggested racial disparity in STI testing in this setting. There have been no studies, however, looking specifically at religion as a factor related to STI testing. In the patient population cared for at our institution, a significant portion are first or second generation immigrants from Somalia and most identify as Muslim. The goal of this study is to determine if patients’ religion (specifically being Muslim) is associated with whether or not physicians obtain STI testing in female adolescents presenting with lower abdominal pain or genitourinary complaints.

Methods: Retrospective study of female patients aged 14-18 presenting to our PED from June 2014 to June 2019 with chief complaint of abdominal pain or genitourinary issue. Electronic medical records were reviewed for demographics including age, race, ethnicity, language spoken, and religion, as well as testing for gonorrhea and chlamydia. Proportions were calculated for frequencies while logistic regression was used to evaluate predictors associated with STI.

Results: 676 patient encounters were identified. Age ranged from 14-18 years. Overall, 130 (19.2%) were tested for STI. 97 patients identified as Muslim (14.7%). After adjusting for age, those of Muslim religion were significantly less likely to be screened for Chlamydia (OR: 0.198; 95% CI: 0.060-0.491) or, Gonorrhea (OR: 0.225; 95% CI: 0.078-0.516).

Conclusion: In adolescent females presenting to a PED for abdominal pain or genitourinary complaints, a small portion were tested for STIs. In particular, those of Muslim religion were significantly less likely to be tested. Future work can be directed at improving screening of all female patients in this setting, with particular focus on addressing any biases that physicians may have in regards to sexual health of Muslim patients.