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Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department

Adolescents with mental illness often seek care in the emergency department (ED) and are more likely to engage in risky behaviors such as substance abuse and unprotected sex, increasing their risk of sexually transmitted infections (STI), unintended pregnancy, and non-consensual sex. This was a retr...

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Autores principales: Vayngortin, Tatyana, Clark, Katie, Hollenbach, Kathryn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9603263/
https://www.ncbi.nlm.nih.gov/pubmed/36293599
http://dx.doi.org/10.3390/ijerph192013018
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author Vayngortin, Tatyana
Clark, Katie
Hollenbach, Kathryn
author_facet Vayngortin, Tatyana
Clark, Katie
Hollenbach, Kathryn
author_sort Vayngortin, Tatyana
collection PubMed
description Adolescents with mental illness often seek care in the emergency department (ED) and are more likely to engage in risky behaviors such as substance abuse and unprotected sex, increasing their risk of sexually transmitted infections (STI), unintended pregnancy, and non-consensual sex. This was a retrospective study of 312 females, aged 13–17 years, presenting to the pediatric ED with the chief complaint of suicidal ideation from February to May 2018. Electronic medical records were reviewed for demographics, psychiatric history, sexual history, and testing for pregnancy or STI. The primary outcome was the documentation of the presence or absence of prior sexual activity. Secondary outcomes included documented aspects of sexual history and pregnancy or STI testing performed in the ED. Of the 312 eligible patients, 144 (46.2%) had a documented sexual history, and of those 50 (34.7%) reported being sexually active. Sexual history documentation was not associated with patient age, race, ethnicity, insurance, or the gender of the ED provider. A history of anxiety and a recent suicide attempt were associated with a lack of sexual history documentation (p = 0.03). Of the sexually active patients, 28 (56%) had documentation of contraception use. Pregnancy testing was performed in 67.3% of all patients and 80% of sexually active patients. Only 10 patients had STI testing in the ED, with most testing occurring in those with sexual history documentation (p = 0.007). In conclusion, more than half of females with suicidal ideation in our ED had no documentation of sexual history, and when documentation was completed, it was often missing important elements, including screening for pregnancy, STI, non-consensual sex, and contraception use. Since the ED visit provides an important opportunity to address the reproductive health needs of this high-risk population, further work is needed to determine ways to improve provider documentation and sexual health screening.
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spelling pubmed-96032632022-10-27 Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department Vayngortin, Tatyana Clark, Katie Hollenbach, Kathryn Int J Environ Res Public Health Article Adolescents with mental illness often seek care in the emergency department (ED) and are more likely to engage in risky behaviors such as substance abuse and unprotected sex, increasing their risk of sexually transmitted infections (STI), unintended pregnancy, and non-consensual sex. This was a retrospective study of 312 females, aged 13–17 years, presenting to the pediatric ED with the chief complaint of suicidal ideation from February to May 2018. Electronic medical records were reviewed for demographics, psychiatric history, sexual history, and testing for pregnancy or STI. The primary outcome was the documentation of the presence or absence of prior sexual activity. Secondary outcomes included documented aspects of sexual history and pregnancy or STI testing performed in the ED. Of the 312 eligible patients, 144 (46.2%) had a documented sexual history, and of those 50 (34.7%) reported being sexually active. Sexual history documentation was not associated with patient age, race, ethnicity, insurance, or the gender of the ED provider. A history of anxiety and a recent suicide attempt were associated with a lack of sexual history documentation (p = 0.03). Of the sexually active patients, 28 (56%) had documentation of contraception use. Pregnancy testing was performed in 67.3% of all patients and 80% of sexually active patients. Only 10 patients had STI testing in the ED, with most testing occurring in those with sexual history documentation (p = 0.007). In conclusion, more than half of females with suicidal ideation in our ED had no documentation of sexual history, and when documentation was completed, it was often missing important elements, including screening for pregnancy, STI, non-consensual sex, and contraception use. Since the ED visit provides an important opportunity to address the reproductive health needs of this high-risk population, further work is needed to determine ways to improve provider documentation and sexual health screening. MDPI 2022-10-11 /pmc/articles/PMC9603263/ /pubmed/36293599 http://dx.doi.org/10.3390/ijerph192013018 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vayngortin, Tatyana
Clark, Katie
Hollenbach, Kathryn
Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department
title Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department
title_full Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department
title_fullStr Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department
title_full_unstemmed Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department
title_short Sexual History Documentation and Screening in Adolescent Females with Suicidal Ideation in the Emergency Department
title_sort sexual history documentation and screening in adolescent females with suicidal ideation in the emergency department
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9603263/
https://www.ncbi.nlm.nih.gov/pubmed/36293599
http://dx.doi.org/10.3390/ijerph192013018
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