Emergency care of urban women with sexually transmitted infections: time to address deficiencies.

BACKGROUND

Patient education upon diagnosis of a sexually transmitted infection (STI) may effect changes in high-risk sexual behavior.

OBJECTIVE

Describe emergency department (ED) communication with urban female patients treated for STIs.

METHODS

: This secondary analysis of data collected during a study of ED communication used mixed quantitative and qualitative methods. The medical records of female patients ages 18 to 35 presenting to an urban ED for low abdominal/pelvic pain, gynecological complaints, and urinary symptoms (n = 134) were reviewed for STI testing and treatment proportions. A subsample of 30 audiotaped interactions with women treated for STIs were coded for provider assessment of sexual risks and delivery of STI prevention messages.

RESULTS

Audiotape analysis found sexual histories were very limited and only 17% of women received prevention messages. Provider STI treatment had an estimated overall sensitivity of 46% (95% CI, 24.4%-69.0%) and specificity of 66% (95% CI, 61.8%-70.7%).

CONCLUSIONS

Urban female patients treated for an STI in the ED rarely received recommended STI prevention messages. The study raises policy issues regarding the need for quality indicators in acute STI care. Access to STI treatment in other practice settings or by alternative methods need to be strongly considered.