Emergency Department and Primary Care Clinical Pathway for Evaluation/Treatment of Sexually Transmitted Infections in Adolescents
- Related Pathways
Adolescents ≥ 13 yrs at Risk for Sexually Transmitted Infection
If < 13 yrs, refer to Sexual Abuse PathwayTriage
Consider urine collection
Consider urine collection
- History
- Asymptomatic infection is common, careful history taking is critical to identify asymptomatic infections
- Community Prevalence, Identifying At-Risk Behaviors
- Signs/Symptoms Consistent with STI
- Five P’s for obtaining sexual histories
- Partners
- Practices
- Protection from STIs
- Past history of STIs
- Pregnancy Intention
- Physical
- Review testing to be completed during visit
- Obtain confidential contact number
- Obtain consent for HIV testing
STI Treatment Recommendations
Consider empiric treatment to avoid complications
- Discharge and Follow-Up Planning
- STI treatment guidance
- Follow-up
- Re-testing
- Emergency contraception
- Expedited partner therapy
- Prevention
- Pre-exposure prophylaxis (PrEP)
- Discharge Instructions
- Communicating STI Results
- Guidance for Delivering HIV Test Results
Evidence
- STI Treatment Guidelines
- Communicating With the Adolescent: Consent and Confidentiality Issues
- Confidential Health Care for Adolescents: Position Paper of the Society for Adolescent Medicine
- Screening for Chlamydia and Gonorrhea—U.S. Preventive Services Task Force Recommendation Statement
- Office-Based Screening for Sexually Transmitted Infections in Adolescents
- An Intervention to Improve Chlamydia and Gonorrhea Testing Among Adolescents in Primary Care