Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
J Adolesc Health. 2010 Mar;46(3):270-7. doi: 10.1016/j.jadohealth.2009.08.003. Epub 2009 Oct 12.
To evaluate the effect of point-of-care (POC) testing for sexually transmitted infections (STIs) on reported awareness of test results and STI risk-reduction behaviors in adolescents.
Adolescent and young adult women aged 14-21 years were recruited from the Emergency Department or Teen Health Clinic for this longitudinal study and were tested for STIs. Baseline demographics, risk behaviors, treatment, POC tests (wet mount and rapid antigen tests for Trichomonas vaginalis), and other STI test results (available 24-48 hours postvisit) were measured. These were compared to subject's report of test results, abstinence, partner discussion, and partner testing during a postvisit telephone contact.
Of 294 subjects, 155 (53%) were contacted: 65 (42%) had a positive STI test result; 28 (43%) were POC positive; and 52 (33.5%) believed their STI results were positive. A positive POC test result increased the proportion of subjects aware of being positive for an STI (89 vs 21%, p < .01). Postvisit, 62% reported abstinence, 82% discussed testing with her partner, and 48% reported partner testing. Predictors of abstinence included a positive POC test result (adjusted odds ratio (AOR) = 4.6, confidence interval (CI) = 1.5-13.6, prior abstinence of >14 days (AOR = 3.9, CI = 1.7-9.0), and black race (AOR = 3.5, CI = 1.2-9.7). Women who believed their STI results were positive were more likely to report partner discussion (odds ratio [OR] = 3.0, CI = 1.0-8.8) and partner testing (OR = 5.1, CI = 2.4-11.2).
Awareness of STI results increases with POC testing. Effective communication of results can increase patient understanding and compliance with risk reduction strategies, which may affect the STI epidemic.
评估即时检测(POC)在性传播感染(STI)方面的效果,以了解其对青少年报告检测结果的意识和减少 STI 风险行为的影响。
这项纵向研究招募了年龄在 14-21 岁的青少年和年轻女性,她们来自急诊科或青少年健康诊所,接受 STI 检测。在就诊后通过电话随访,收集基线人口统计学资料、风险行为、治疗、POC 检测(湿片和快速抗原检测阴道毛滴虫)以及其他 STI 检测结果(就诊后 24-48 小时)。这些数据与受试者对检测结果、禁欲、伴侣讨论和伴侣检测的报告进行了比较。
在 294 名受试者中,有 155 名(53%)进行了联系:65 名(42%)检测结果呈阳性;28 名(43%)POC 阳性;52 名(33.5%)认为自己的 STI 检测结果呈阳性。POC 阳性检测结果增加了报告意识到 STI 阳性的受试者比例(89%比 21%,p <.01)。就诊后,62%的人报告禁欲,82%的人与伴侣讨论了检测,48%的人报告了伴侣检测。禁欲的预测因素包括 POC 阳性检测结果(调整后的优势比(AOR)=4.6,置信区间(CI)=1.5-13.6,14 天以上的先前禁欲(AOR=3.9,CI=1.7-9.0)和黑种人(AOR=3.5,CI=1.2-9.7)。认为自己的 STI 检测结果呈阳性的女性更有可能报告伴侣讨论(比值比(OR)=3.0,CI=1.0-8.8)和伴侣检测(OR=5.1,CI=2.4-11.2)。
随着 POC 检测的应用,对 STI 检测结果的意识增强。有效的检测结果沟通可以增加患者对风险降低策略的理解和依从性,这可能会影响 STI 的流行。