Generalizability of STD screening in urban emergency departments: Comparison of results from inner city and urban sites in Baltimore, Maryland

Supriya D. Mehta, Anne Marie Rompalo, Richard Rothman, M. S. Londner, Jonathan Mark Zenilman

Research output: Contribution to journalArticle

Abstract

Background: A previous study in an inner city emergency department (ED) in Baltimore, Maryland, showed a high prevalence of gonorrhea and chlamydia infection among ED patients. Goal: The goal was to compare results from an inner city ED to results from an urban ED in Baltimore, in terms of study population and setting, risks for infection, and factors associated with nonparticipation in the study. Methods: This was a cross-sectional study of patients aged 14 to 44 years at two EDs. Outcomes for multivariate logistic regression analyses were (1) positive for gonorrhea or chlamydia by urine ligase chain reaction assay and (2) nonparticipation in the study. Comparative analyses were limited to patients aged 18 to 31 years. Results: Patients differed significantly between EDs by participation rate, distribution of race/ethnicity, healthcare access, and behavioral risks, although the prevalence of infection did not differ. Risks for infection at the inner city ED were younger age, history of STD, and recent number of sex partners. Risks for infection at the urban ED were female gender and recent number of sex partners. At both EDs, being African American was associated with increased chance of participating, whereas lack of any genitourinary complaint was associated with nonparticipation. At the urban ED, women and patients approached for study enrollment during the day were also less likely to participate. Conclusion: ED-based screening for STDs can be an effective intervention for unrecognized infections. However, assessing population characteristics is necessary to develop targeted screening methods and clinical algorithms and to improve participation of patients and program sustainability.

Original languageEnglish (US)
Pages (from-to)143-148
Number of pages6
JournalSexually Transmitted Diseases
Volume30
Issue number2
DOIs
StatePublished - Feb 1 2003

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Baltimore
Sexually Transmitted Diseases
Hospital Emergency Service
Infection
Gonorrhea
Ligase Chain Reaction
Patient Participation
Chlamydia Infections
Chlamydia
Program Evaluation
Population Characteristics
African Americans
Cross-Sectional Studies
Logistic Models
Regression Analysis
Urine
Delivery of Health Care

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)

Cite this

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title = "Generalizability of STD screening in urban emergency departments: Comparison of results from inner city and urban sites in Baltimore, Maryland",
abstract = "Background: A previous study in an inner city emergency department (ED) in Baltimore, Maryland, showed a high prevalence of gonorrhea and chlamydia infection among ED patients. Goal: The goal was to compare results from an inner city ED to results from an urban ED in Baltimore, in terms of study population and setting, risks for infection, and factors associated with nonparticipation in the study. Methods: This was a cross-sectional study of patients aged 14 to 44 years at two EDs. Outcomes for multivariate logistic regression analyses were (1) positive for gonorrhea or chlamydia by urine ligase chain reaction assay and (2) nonparticipation in the study. Comparative analyses were limited to patients aged 18 to 31 years. Results: Patients differed significantly between EDs by participation rate, distribution of race/ethnicity, healthcare access, and behavioral risks, although the prevalence of infection did not differ. Risks for infection at the inner city ED were younger age, history of STD, and recent number of sex partners. Risks for infection at the urban ED were female gender and recent number of sex partners. At both EDs, being African American was associated with increased chance of participating, whereas lack of any genitourinary complaint was associated with nonparticipation. At the urban ED, women and patients approached for study enrollment during the day were also less likely to participate. Conclusion: ED-based screening for STDs can be an effective intervention for unrecognized infections. However, assessing population characteristics is necessary to develop targeted screening methods and clinical algorithms and to improve participation of patients and program sustainability.",
author = "Mehta, {Supriya D.} and Rompalo, {Anne Marie} and Richard Rothman and Londner, {M. S.} and Zenilman, {Jonathan Mark}",
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T1 - Generalizability of STD screening in urban emergency departments

T2 - Comparison of results from inner city and urban sites in Baltimore, Maryland

AU - Mehta, Supriya D.

AU - Rompalo, Anne Marie

AU - Rothman, Richard

AU - Londner, M. S.

AU - Zenilman, Jonathan Mark

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N2 - Background: A previous study in an inner city emergency department (ED) in Baltimore, Maryland, showed a high prevalence of gonorrhea and chlamydia infection among ED patients. Goal: The goal was to compare results from an inner city ED to results from an urban ED in Baltimore, in terms of study population and setting, risks for infection, and factors associated with nonparticipation in the study. Methods: This was a cross-sectional study of patients aged 14 to 44 years at two EDs. Outcomes for multivariate logistic regression analyses were (1) positive for gonorrhea or chlamydia by urine ligase chain reaction assay and (2) nonparticipation in the study. Comparative analyses were limited to patients aged 18 to 31 years. Results: Patients differed significantly between EDs by participation rate, distribution of race/ethnicity, healthcare access, and behavioral risks, although the prevalence of infection did not differ. Risks for infection at the inner city ED were younger age, history of STD, and recent number of sex partners. Risks for infection at the urban ED were female gender and recent number of sex partners. At both EDs, being African American was associated with increased chance of participating, whereas lack of any genitourinary complaint was associated with nonparticipation. At the urban ED, women and patients approached for study enrollment during the day were also less likely to participate. Conclusion: ED-based screening for STDs can be an effective intervention for unrecognized infections. However, assessing population characteristics is necessary to develop targeted screening methods and clinical algorithms and to improve participation of patients and program sustainability.

AB - Background: A previous study in an inner city emergency department (ED) in Baltimore, Maryland, showed a high prevalence of gonorrhea and chlamydia infection among ED patients. Goal: The goal was to compare results from an inner city ED to results from an urban ED in Baltimore, in terms of study population and setting, risks for infection, and factors associated with nonparticipation in the study. Methods: This was a cross-sectional study of patients aged 14 to 44 years at two EDs. Outcomes for multivariate logistic regression analyses were (1) positive for gonorrhea or chlamydia by urine ligase chain reaction assay and (2) nonparticipation in the study. Comparative analyses were limited to patients aged 18 to 31 years. Results: Patients differed significantly between EDs by participation rate, distribution of race/ethnicity, healthcare access, and behavioral risks, although the prevalence of infection did not differ. Risks for infection at the inner city ED were younger age, history of STD, and recent number of sex partners. Risks for infection at the urban ED were female gender and recent number of sex partners. At both EDs, being African American was associated with increased chance of participating, whereas lack of any genitourinary complaint was associated with nonparticipation. At the urban ED, women and patients approached for study enrollment during the day were also less likely to participate. Conclusion: ED-based screening for STDs can be an effective intervention for unrecognized infections. However, assessing population characteristics is necessary to develop targeted screening methods and clinical algorithms and to improve participation of patients and program sustainability.

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