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Abigail Silva, MPH1, Nancy Glick, MD2, Dawn Broussard, MPH3, Sheryl B. Lyss, MD4, and Steven Whitman, PhD1. (1) Sinai Health System, Sinai Urban Health Institute, California at 15th Street, K439, Chicago, IL 60608, 773-257-5785, sila@sinai.org, (2) Department of Medicine, Mount Sinai Hospital, California Avenue at 15th Street, Chicago, IL 60608, (3) STD/HIV Prevention and Care Program, Chicago Dept. of Public Health, 530 E. 31st Street, 2nd floor, Chicago, IL 46321, (4) Division of Reproductive Health, Centers for Disease Control and Prevention, Mailstop K-22, 4770 Buford Highway NE, Atlanta, GA 30341
Background: Patients in emergency departments (EDs) commonly have asymptomatic sexually transmitted infections (STIs), and many are willing to be tested for them. Less is known about whether infected patients identified through ED screening are successfully treated or whether such screening is feasible in resource-poor, inner-city hospitals in high prevalence communities. Collaboration with health departments (HDs) may influence the feasibility and effectiveness of such screening.
Objectives: To determine STI prevalence and the feasibility and effectiveness of STI screening in an inner-city ED.
Methods: As part of an on-going study assessing routine, voluntary HIV/STD screening, ED patients aged 15 to 25 years were offered free chlamydia and gonorrhea testing Monday-Friday, 10AM-8PM. Patients not being treated for STI symptoms at the current visit were eligible. The HD paid for collection kits and nucleic acid amplification testing on urine samples and helped contact infected patients who were difficult to find. Infected patients were referred to a HD or hospital-based clinic for free treatment.
Results: To date, 348 patients were approached, and 149 (43%) consented to screening. Consenting patients were similar in sex, age, and race/ethnicity to those who refused. Of 127 patients providing urine, 16 tested positive for chlamydia only, 2 for gonorrhea only, and 3 for both. Prevalence was 15% for chlamydia and 4% for gonorrhea. 2% had both. Of 21 patients with an STI, 18 (86%) received treatment.
Conclusions: Integrating STI screening into routine ED care is feasible with health department collaboration. With such screening, many ED patients with asymptomatic STIs can be identified and treated.
Learning Objectives: Participants in this session will be able to
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.