Point-of-Care Testing for Sexually Transmitted Infections Increases Awareness and Short-Term Abstinence in Adolescent Women
Received 22 May 2009; accepted 5 August 2009. published online 12 October 2009.
Abstract
Purpose
To evaluate the effect of point-of-care (POC) testing for sexually transmitted infections (STIs) on reported awareness of test results and STI risk-reduction behaviors in adolescents.
Methods
Adolescent and young adult women aged 14–21 years were recruited from the Emergency Department or Teen Health Clinic for this longitudinal study and were tested for STIs. Baseline demographics, risk behaviors, treatment, POC tests (wet mount and rapid antigen tests for Trichomonas vaginalis), and other STI test results (available 24–48 hours postvisit) were measured. These were compared to subject's report of test results, abstinence, partner discussion, and partner testing during a postvisit telephone contact.
Results
Of 294 subjects, 155 (53%) were contacted: 65 (42%) had a positive STI test result; 28 (43%) were POC positive; and 52 (33.5%) believed their STI results were positive. A positive POC test result increased the proportion of subjects aware of being positive for an STI (89 vs 21%, p < .01). Postvisit, 62% reported abstinence, 82% discussed testing with her partner, and 48% reported partner testing. Predictors of abstinence included a positive POC test result (adjusted odds ratio (AOR) = 4.6, confidence interval (CI) = 1.5–13.6, prior abstinence of >14 days (AOR = 3.9, CI = 1.7–9.0), and black race (AOR = 3.5, CI = 1.2–9.7). Women who believed their STI results were positive were more likely to report partner discussion (odds ratio [OR] = 3.0, CI = 1.0–8.8) and partner testing (OR = 5.1, CI = 2.4–11.2).
Conclusions
Awareness of STI results increases with POC testing. Effective communication of results can increase patient understanding and compliance with risk reduction strategies, which may affect the STI epidemic.
aDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
bUniversity of Cincinnati College of Medicine, Cincinnati, Ohio
cDivision of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
Address correspondence to: Jennifer L. Reed, M.D., Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 2008, Cincinnati, OH 45229.