This retrospective, single-center study examined STI rates among pediatric sexual assault patients (ages 0–17) and PEP prescription fill rates among STI-positive adolescents (ages 12–17) seen in a pediatric ED from March 2022 to September 2024.
Of 459 total patients, 39 (8.5%) tested positive for gonorrhea, chlamydia, or both; 34 were adolescents. Among the 17 adolescent STI-positive patients with known prescription outcomes, only 12 (70.6%) filled prescriptions, 10 (58.8%) started medications, and just 6 (35.3%) completed the full course.
- Single-center, retrospective design limits generalizability. - Prescription outcome data was available for only 17 of 31 discharged adolescents, introducing significant ascertainment bias. - No comparison group or multivariate analysis to identify modifiable predictors of non-adherence.
Over one-third of STI-positive adolescent sexual assault patients never filled their PEP prescription, and fewer than half completed treatment — consider dispensing medications directly in the ED rather than issuing prescriptions to take out. Systematic follow-up by SANE teams can identify gaps but alone is insufficient to ensure adherence.
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