A retrospective review of the rate of sexually transmitted infections in adolescents after universal screening protocol implementation in an urban United States clinic.

OBJECTIVE

Despite expanded guidelines, adolescent gonorrhea and chlamydia (GC/CT) screening rates remain low due to multiple psychosocial barriers and biases. This intervention aimed to improve screening and diagnosis rates at adolescent well visits by establishing a streamlined universal screening protocol for all patients ages 13-18 years old.

METHODS

A universal sexually transmitted infection (STI) screening approach was introduced at an urban clinic affiliated with an academic medical center near Philadelphia, Pennsylvania (PA) in September 2018 for all adolescent well-visits. GC/CT screening and diagnosis rates were compared two years prior to and two years after implementation, deemed the baseline and intervention groups, respectively.

RESULTS

In total, 1,168 encounters were included for analysis. The patient cohort consisted of 47% females, with an average age of 15, and were predominantly publicly insured (79%). STI screening rates increased significantly from 16.7% (89/534) to 83.6% (530/634) of adolescents with implementation of the universal screening protocol. Furthermore, there was a 1.6-fold increase in total positive cases detected after implementation of ok universal screening.

CONCLUSION

This study demonstrates improved adolescent GC/CT capture rates by establishing a universal screening protocol and highlights a streamlined means of implementation in virtually any pediatric clinic. Limitations include sample size, as this is a single academic practice, as well as any issues with lab collection and results reporting.