Sexually transmitted infection testing and diagnosis in adolescents and young adults with sickle cell disease

• Published in: Pediatric blood & cancer Vol. 71; no. 10; pp. e31240 - n/a
• Main Authors: Walden, Joseph, Stanek, Joseph R., Ebersole, Ashley M., Nahata, Leena, Creary, Susan E.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.10.2024
• Subjects: Adolescent; Adolescents; Adult; Anemia, Sickle Cell - diagnosis; Anemia, Sickle Cell - epidemiology; Black or African American - statistics & numerical data; Chronic infection; Cross-Sectional Studies; Diagnosis; Emergency medical care; Female; Follow-Up Studies; health disparity; health equity; Humans; Male; Pediatrics; Retrospective Studies; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - epidemiology; sexually transmitted infection; Sickle cell disease; STD; Young Adult; Young adults; health disparity; adolescent; health equity; young adult; sexually transmitted infection; sickle cell disease
• ISSN: 1545-5009; 1545-5017; 1545-5017
• DOI: 10.1002/pbc.31240

Background Sexually transmitted infections (STIs) are common and disproportionately affect Black adolescents and young adults (AYAs). Less is known about STIs among Black AYAs with chronic conditions, such as sickle cell disease (AYAs‐SCD). This study compared STI testing and diagnosis between AYAs‐SCD and their peers, overall and among STI‐related encounters. Procedure This retrospective, cross‐sectional study used diagnosis and billing codes in the Pediatric Health Information System (PHIS) to identify inpatient and emergency department encounters from January 1, 2022 to May 31, 2023 among all AYAs 15–24 years and those with STI‐related diagnoses (e.g., “cystitis”). STI testing and diagnosis rates were compared between AYAs‐SCD, non‐Black AYAs, and Black AYAs, controlling for age, sex, and encounter setting. Results We identified 3602 AYAs‐SCD, 177,783 Black AYAs, and 534,495 non‐Black AYAs. AYAs‐SCD were less likely to be tested for STIs than non‐Black AYAs (odds ratio [OR] = 0.26; adj. p < .001) and Black AYAs (OR = 0.53; adj. p < .001). When tested, AYAs‐SCD were more likely to be diagnosed with an STI than non‐Black AYAs (OR = 2.39; adj. p = .006) and as likely as Black AYAs (OR = 0.67; adj. p = .15). Among STI‐related encounters, AYAs‐SCD were less likely to be tested than non‐Black AYAs (OR = 0.18; adj. p < .001) and Black AYAs (OR = 0.44; adj. p < .001). No significant differences in STI diagnoses were found in this subset between AYAs‐SCD and non‐Black AYAs (OR = 0.32; adj. p = .28) or Black AYAs (OR = 1.07; adj. p = .99). Conclusions STI care gaps may disproportionately affect AYAs‐SCD. STIs should be considered when evaluating symptomatic AYAs‐SCD in acute settings. More research is needed to further contextualize STI care for AYAs‐SCD.