PC2015: Pediatric Sex ED: Knowledge Assessment of Sexually Transmitted Infections in an Urban Pediatric Emergency Department (ED)

Purpose/Objectives: Sexually Transmitted Infections (STIs) disproportionately affect adolescents and racial minorities. Youth utilize the ED at higher rates than primary care offices for STI concerns. The UF Health Jacksonville Pediatric ED commonly treats adolescents for STIs, including recurrent STIs when sexual practices don’t change. Sexual education has the potential to reduce the spread of STIs, but there are limited national data on youth STI knowledge in the United States and no data on STI knowledge of the adolescents presenting to the ED. We endeavored to assess the STI knowledge of adolescents and youth seeking ED care for STIs and compare their knowledge with the results from a national survey of Australian youth. We plan to use these results to inform a quality improvement project aimed at increasing knowledge and decreasing reinfections among these adolescents.

Design/Methods: Adolescents ages 16-20 who presented to the ED with chief complaints indicative of an STI completed surveys adapted from the National Survey of Australian Secondary Students and Sexual Health 2018. We calculated the average percent correct per question (Table 1) and compared the proportion correct between our sample and the Australian sample using chi-squared analysis (Figure 1) with a p value of < 0.5 considered significant.

Results: We collected 25 surveys. Most participants recognized symptoms of STIs. However, only 48% were aware of the limitations of condoms in preventing STIs. The greatest knowledge limitations identified in our participants were in categories of transmission and consequences. In comparison with the Australian survey, our participants scored significantly lower on recognizing limitations of condoms (48% vs 86%, p< 0.0001). However, our participants scored significantly higher on chlamydia causing sterility (84% vs 52%, p=0.001), oral transmission of gonorrhea (84% vs 61%, p=0.02) and the consequences of Human Papilloma Virus (HPV) (68% vs 23% p< 0.0001). While only 72% of our participants identified herpes as incurable, this was significantly higher than the 38% reported in the Australian survey (p < 0.001).

Conclusion/Discussion: A knowledge assessment was conducted on 25 adolescents presenting to the ED with symptoms suggestive of STIs. We identified gaps in knowledge in the categories of STI transmission (especially condom limitations) and consequences. Furthermore, we detected differences and similarities between our population and the national Australian sample. Australian students were more aware of condom limitations; however, our participants were more aware of STI symptomology, transmission of gonorrhea through oral sex, and chlamydia leading to sterility. Both groups showed limited knowledge on HPV transmission and STI curability. These findings demonstrate the importance of assessing adolescents’ knowledge locally before embarking on an educational or improvement effort. Limitations include our small sample size and only offering the surveys in English.