Jenkins Wiley D, LeVault Kelsey R
Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, Illinois; Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, Illinois.
Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, Illinois.
J Emerg Med. 2015 Feb;48(2):143-51. doi: 10.1016/j.jemermed.2014.06.051. Epub 2014 Oct 2.
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the most reported diseases in the United States, and emergency departments (ED) serve a population presenting with increased infection risk. However, identifying patients for whom sexually transmitted infection (STI) screening is appropriate requires accurate sexual history reporting.
To examine the consistency with which ED patients answer general and specific sexual activity questions, and how responses relate to perceived STI risk.
Urban ED patients aged 15-34 years completed a sexual history survey containing sexual activity and perceived infection risk questions and provided urine and pharyngeal specimens for CT/GC analysis.
Participants included 192 males and 301 females with a mean age of 25.2 years and were 65.7% white and 33.3% black. Thirty-eight (7.7%) were infected with CT or GC. In patients denying sexual activity in the past year (general question), 40.7% of such males and 45.0% of females also reported some form of specific sexual activity (activity misclassification). Among self-identified heterosexuals, 7.2% males and 7.5% females reported some form of homosexual activity (orientation misclassification; OM). OM individuals were more likely to perceive themselves at risk of infection both orally (odds ratio 2.92, confidence interval 1.12-7.63) and genitally (odds ratio 3.36, confidence interval 1.55-7.30).
Given that reported sexual activity and age are the only criteria for routine female screening, and that homosexual activity is one of the few screening criteria for males, our results show that a substantial proportion of ED patients eligible for screening may not be identified by reliance upon general sexual history questions.
沙眼衣原体（CT）和淋病奈瑟菌（GC）是美国报告最多的疾病，急诊科（ED）接待的人群感染风险较高。然而，要确定适合进行性传播感染（STI）筛查的患者，需要准确的性史报告。
研究急诊科患者回答一般性和特异性性行为问题的一致性，以及这些回答与感知到的性传播感染风险之间的关系。
15至34岁的城市急诊科患者完成了一项性史调查，其中包含性行为和感知感染风险问题，并提供尿液和咽拭子样本用于CT/GC分析。
参与者包括192名男性和301名女性，平均年龄为25.2岁，65.7%为白人，33.3%为黑人。38人（7.7%）感染了CT或GC。在过去一年否认有性行为（一般性问题）的患者中，40.7%的男性和45.0%的女性也报告了某种形式的特异性性行为（行为错误分类）。在自我认定为异性恋的人群中，7.2%的男性和7.5%的女性报告了某种形式的同性恋行为（性取向错误分类；OM）。OM个体更有可能认为自己有口腔感染风险（优势比2.92，置信区间1.12 - 7.63）和生殖器感染风险（优势比3.36，置信区间1.55 - 7.30）。
鉴于报告的性行为和年龄是常规女性筛查的唯一标准，而同性恋行为是男性少数筛查标准之一，我们的结果表明，依靠一般性史问题可能无法识别出很大一部分符合筛查条件的急诊科患者。
