Meeting NewsPerspective

Few adolescents with PID screened for HIV, syphilis

Less than a third of adolescent girls diagnosed with pelvic inflammatory disease in the ED were also screened for syphilis and HIV, according to a study presented at the Pediatric Academic Societies meeting.

“The frequency of HIV and syphilis testing in adolescents diagnosed with [pelvic inflammatory disease] has been under-investigated,” Amanda Jichlinski, MD, resident physician of pediatrics at the Children's National Health System, and colleagues wrote.

Researchers retrospectively analyzed records of 10,698 females in the Pediatric Health Information System aged 12 to 21 years diagnosed with pelvic inflammatory disease while in the ED from 2010 to 2015.

Jichlinski and colleagues found 27.7% underwent syphilis screening and 22% of the females underwent HIV screening.

Multivariable analysis revealed HIV screening was more likely in those aged 12 to 16 years (adjusted OR = 1.2; 95% CI, 1-1.3), patients in hospitals with fewer than 300 beds (aOR = 1.4; 95% CI 1-1.8), non-Hispanic blacks (aOR = 1.4; 95% CI, 1.2-1.7), publicly insured patients (aOR = 1.3; 95% CI 1.1-1.5), uninsured patients (aOR = 1.6; 95% CI, 1.2-2), and patients admitted to the hospital (aOR = 7; 95% CI 5.1-9.4).

In addition, syphilis testing was more likely in those aged 12 to 16 years (aOR = 1.1; 95% CI, 1-1.3), publicly insured patients (aOR = 1.4; 95% CI, 1.2-1.6], uninsured patients (aOR = 1.6; 95% CI, 1.2-1.9), non-Hispanic blacks (aOR = 1.8; 95% CI 1.2-2.8), and patients admitted to the hospital (aOR = 4.6; 95% CI, 3.3-6.4).

“The results indicate the need for more education and systems improvements to improve compliance of [pelvic inflammatory disease] management in children’s hospital EDs,” Jichlinski and colleagues concluded. – by Janel Miller

Reference: Jichlinski A, et al. HIV and syphilis screening among adolescents with pelvic inflammatory disease. Presented at: Pediatric Academic Societies meeting; May 5-8, 2018; Toronto.

Disclosure: Healio Family Medicine was unable to determine the authors’ relevant financial disclosures prior to publication.

Less than a third of adolescent girls diagnosed with pelvic inflammatory disease in the ED were also screened for syphilis and HIV, according to a study presented at the Pediatric Academic Societies meeting.

“The frequency of HIV and syphilis testing in adolescents diagnosed with [pelvic inflammatory disease] has been under-investigated,” Amanda Jichlinski, MD, resident physician of pediatrics at the Children's National Health System, and colleagues wrote.

Researchers retrospectively analyzed records of 10,698 females in the Pediatric Health Information System aged 12 to 21 years diagnosed with pelvic inflammatory disease while in the ED from 2010 to 2015.

Jichlinski and colleagues found 27.7% underwent syphilis screening and 22% of the females underwent HIV screening.

Multivariable analysis revealed HIV screening was more likely in those aged 12 to 16 years (adjusted OR = 1.2; 95% CI, 1-1.3), patients in hospitals with fewer than 300 beds (aOR = 1.4; 95% CI 1-1.8), non-Hispanic blacks (aOR = 1.4; 95% CI, 1.2-1.7), publicly insured patients (aOR = 1.3; 95% CI 1.1-1.5), uninsured patients (aOR = 1.6; 95% CI, 1.2-2), and patients admitted to the hospital (aOR = 7; 95% CI 5.1-9.4).

In addition, syphilis testing was more likely in those aged 12 to 16 years (aOR = 1.1; 95% CI, 1-1.3), publicly insured patients (aOR = 1.4; 95% CI, 1.2-1.6], uninsured patients (aOR = 1.6; 95% CI, 1.2-1.9), non-Hispanic blacks (aOR = 1.8; 95% CI 1.2-2.8), and patients admitted to the hospital (aOR = 4.6; 95% CI, 3.3-6.4).

“The results indicate the need for more education and systems improvements to improve compliance of [pelvic inflammatory disease] management in children’s hospital EDs,” Jichlinski and colleagues concluded. – by Janel Miller

Reference: Jichlinski A, et al. HIV and syphilis screening among adolescents with pelvic inflammatory disease. Presented at: Pediatric Academic Societies meeting; May 5-8, 2018; Toronto.

Disclosure: Healio Family Medicine was unable to determine the authors’ relevant financial disclosures prior to publication.

    Perspective

    Routine screening for other STDs such as HIV and syphilis in young women presenting with pelvic inflammatory disease is a valuable opportunity to diagnose these two often clinically silent infections. Earlier identification and treatment translates into decreases in both transmission to uninfected partners and morbidity.

    Also, because these young women represent a cohort engaging in condom-less sex, negative HIV testing affords clinicians an opportunity to discuss additional preventive strategies such as pre-exposure prophylaxis.

    • Raffaele Bernardo, DO
    • Infectious Diseases, Montefiore Health System, assistant professor, Department of Medicine, Albert Einstein College of Medicine

    Disclosures: Bernardo reports no relevant financial disclosures.

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