Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-10-2019

Graduate Advisor

Dr. Laura Kuensting, DNP, APRN, PCNS-BC, CPNP, CPEN

Committee

Dr. Elizabeth (Lisa) Merritt, DNP, APRN, CPNP-PC/AC, PMHS

Lauren Norrenberns, MSN, APRN, CPNP-PC

Abstract

Abstract

Problem Adolescents are contracting sexually transmitted infections (STIs) with half of all new STIs occurring in those aged 15-24 years old. The American Academy of Pediatrics, recommended all sexually active adolescents be screened for STIs. Incorporation of a sexual behavior assessment may assist providers with identifying STI risk.

Methods A descriptive design comparing three cohorts of adolescents presenting for a well-exam. The cohorts analyzed were: urine screening on all adolescents, urine screening for only those reporting sexual activity, and a self-administered sexual history questionnaire tool, based on the HEEADSSS psychosocial assessments.

Results The majority (97%), of all three cohorts (N=60), had a documented sexual history in the medical record. A chi-square analysis between cohort one and two (n=49) comparing sexual history and urine STI testing (χ2= 5.72, p= .057), and comparing urine STI testing with a positive urine test (χ2= 0.04, p= .837) was essentially unremarkable. A statistical analysis could not be conducted comparing cohort three with cohort one or cohort two due to incomplete sampling. Overall, about 20% tested positive for an STI when screened routinely or if the adolescent reported sexual activity.

Implications For Practice Urine screening for STI improved the identification of an STI in adolescents and is of clinical significance. Assessment of sexual activity and STI risk may be improved when private time between the adolescent and provider are available, or through a paper assessment tool completed by the adolescent without a parent present.

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