ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2025
Low sexually transmitted infection (STI) screening and presumptive treatment and high STI positivity among United States females visiting the emergency department after sexual assault.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- One in two sexual assault survivors leave the emergency department without an Initial Medical Certificate: gaps in medico-legal documentation in two Paris emergency departments.International journal of emergency medicine · 2026Article
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3 authors.
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Abstract
objectiveThe Centers for Disease Control and Prevention sexually transmitted infection (STI) treatment guidelines state that the decision to provide STI/human immunodeficiency virus (HIV) testing and presumptive treatment after sexual assault (SA) should be made on an individual basis to minimize retraumatization of the patient. However, little is known about STI screening, presumptive treatment, and positivity in the emergency department (ED) setting. The objective of this study was to evaluate STI testing rates and positivity, presumptive gonorrhea and chlamydia treatment, pregnancy testing, and emergency contraception offered to SA survivors in the ED in the United States.
methodsThe Premier Healthcare Database, a national administrative data set containing health care information from inpatient and hospital-based outpatient encounters, was used. Approximately 30% of encounters have available laboratory test results. ED visits for SA (identified by ICD-10-CM codes) among female patients aged 15-44 years between 2019 and 2023 were included. For patients presenting multiple times to the ED, only the first ED visit after SA was included.
resultsOf 49,047 total visits where females ages 15-44 years presented to the ED for SA, chlamydia, gonorrhea, syphilis, and HIV tests were conducted in 18.6%, 18.6%, 13.4%, and 16.9%, respectively, and pregnancy tests in 33.1% of visits. Presumptive gonorrhea and chlamydia treatment was provided in 53.7% and 52.2%, respectively, and emergency contraception in 27.2% of visits. Approximately 40% of patients were neither tested nor treated for either chlamydia or gonorrhea. Of patients with available laboratory test results, chlamydia, gonorrhea, and syphilis positivity rates were 10.0%, 3.8%, and 1.0%, respectively.
conclusionsLow STI testing and treatment rates and high STI positivity identified in this study suggest that an important opportunity exists for improving STI screening and presumptive treatment for female patients presenting to the ED after SA.
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