Few Young Women With PID Screened for HIV or Syphilis

20 percent of the nearly 1 million cases of pelvic inflammatory disease (PID) that are diagnosed each year occur in young women, with the majority of diagnoses made in EDs.

New research said 10,698 diagnosed cases of pelvic inflammatory disease (PID) were reported among young women aged 12 to 21 during 2010-2015. Out of which 27.7 percent of these women underwent syphilis screening, 22 percent were screened for HIV, and only 18.4 percent underwent lab testing for both HIV and syphilis. The findings of the study are published in Pediatrics.

A team of researchers at Children's National Health System reviewed de-identified data from the Pediatric Health Information System, a database that aggregates encounter-level data from 48 children's hospitals across the nation.

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‘Few adolescent females diagnosed with pelvic inflammatory disease in the nation's pediatric emergency departments (ED) undergo laboratory tests for HIV or syphilis.’

Screening rates varied dramatically by hospital, with some facilities screening just 2 percent of high-risk young women while others tested more than 60 percent.

HIV screening was more likely to occur among:

Women admitted to the hospital, compared with those discharged from the ED (adjusted odds ratio [aOR] of 7.0)

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Uninsured women, compared with women with private insurance (1.6 aOR)

Non-Latino African American women, compared with non-Latino white women (1.4 aOR)

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Women seen at small hospitals with fewer than 300 beds (1.4 aOR) Women with public insurance compared with women with private insurance (1.3 aOR)

12-year-olds to 16-year-olds, compared with older adolescents (1.2 aOR)

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Syphilis screening was more likely to occur for: Women admitted to the hospital (4.6 aOR)

Non-Latino African American women (1.8 aOR)

Uninsured women (1.6 aOR)

Women with public insurance (1.4 aOR)

12-year-olds to 16-year-olds (1.1 aOR)

"It is encouraging that HIV and syphilis screening rates for women with PID increased over the study period. However, our findings point to missed opportunities to safeguard young women's reproductive health," says Monika K. Goyal, M.D., M.S.C.E., assistant professor of Pediatrics and Emergency Medicine and the study's senior author. "Such discrepancies in screening across the 48 hospitals we studied underscore the need for a standardized approach to sexually transmitted infection (STI) screening."

Untreated STIs can cause PID, an infection of a woman's reproductive organs that can complicate her ability to get pregnant and also can cause infertility. Since 2006, the Centers for Disease Control and Prevention (CDC) has recommended that all women diagnosed with PID be tested for HIV. The CDC's treatment guidelines also recommend screening people at high risk for syphilis.

"Syphilis infection rates have steadily increased each year, and it is now most prevalent among young adults," Dr. Goyal says. "Future research should examine how STI screening can be improved in emergency departments, especially since adolescents at high risk for STIs often access health care through EDs. We also should explore innovative approaches, including electronic alerts and shared decision-making to boost STI screening rates for young women."

Source-Eurekalert