370 - Sex trafficking screening in the emergency department: correlation with sexually transmitted infection testing and positive results.
Monday, May 1, 2023
9:30 AM – 11:30 AM ET
Poster Number: 370 Publication Number: 370.404
Kari Schneider, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Loralie J. Peterson, University of Minnesota Medical School, Minneapolis, MN, United States; Scott Lunos, University of Minnesota, Minneapolis, MN, United States; Nancy S. Harper, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States
Assistant Professor University of Minnesota Masonic Children's Hospital Minneapolis, Minnesota, United States
Background: Sex trafficking of youth is a significant global concern with youth at risk for medical, psychological, and sexual health issues.Studies suggest that a large proportion of individuals do seek health care during/around the time of their exploitation, especially to emergency departments (EDs).There are validated screening tools for child sex trafficking (CST) - such as the 6-item Short Screen for Child Sex Trafficking (SSCST) - that can be used with youth seeking care in the ED.There is a paucity of literature, however, regarding how these tools relate to providers obtaining sexually transmitted infection (STI) screening or to positive STI tests in youth. Objective: To determine the proportion of youth evaluated with SSCST who have STI testing and how many of these have a positive test result.Additionally, to evaluate whether any of the individual SSCST screening questions correlate with STI testing or a positive test. Design/Methods: Retrospective study of patients aged 11 through 17 years that presented to the ED between April 2022 and December 2022 with a chief complaint that triggered SSCST screening. Proportions were calculated for frequencies and Fisher’s exact tests evaluated factors associated with STI screening and test results. Results: 3,290 youth aged 11-17 presented to the ED in the time period with a high risk chief complaint. Of those, 2,494 (76%) were screened and 551 (22%) had a positive SSCST defined as a score of ≥3.A forensic nurse examiner formally evaluated 269 (49%) for CST.Of the 269, mean age was 15.2 and 75.8% were female.Chief complaints associated with suicidality triggered screening in 111 (41.3%).Serology was obtained on 55 patients (21.5%), 1 of whom was positive, and urine testing on 78 (29%), 17 of whom were positive.More females than males had STI testing (33.8% vs 13.8%, p=0.0016).Those with STI testing had higher rates of reporting a prior STI (p=0.0468), reporting more sexual partners (p< 0.0001), and having lower rates of problems with the police (p=0.0264) on screening questions.There were no statistically significant associations, however, between the SSCST screening questions and STI test results.
Conclusion(s): STI testing was obtained on less than 1/3 of youth considered at risk for CST.Testing was more likely to be obtained in youth that reported prior STI or more sexual partners, but a positive STI test did not correlate with any of the SSCST screening questions.Efforts can be made to increase testing in youth at high risk of sex trafficking.
