209 - Integration of Comprehensive Preventive Services for Adolescents Diagnosed with STIs in Pediatric Emergency Departments

Publication Number: 2201.209

Lauren Middlebrooks, Emory University School of Medicine, Atlanta, GA, United States; sandy Francois, Emory University School of Medicine, Atlanta, GA, United States; Melissa Brooks, Emory University School of Medicine Department of Pediatric Emergency Medicine, Atlanta, GA, United States; Jordan E. Bryant, Emory University School of Medicine, Atlanta, GA, United States; Bridget Wynn, Emory University School of Medicine, Atlanta, GA, United States; Sara P. Brown, Children's Healthcare of Atlanta, Atlanta, GA, United States; Sarah Thompson, Children's Healthcare of Atlanta, Atlanta, GA, United States; Rebekah carter, Children's Healthcare of Atlanta, Atlanta, GA, United States; Kelly DeNaples, Children's Healthcare of Atlanta, Atlanta, GA, United States; kandaswamy swaminathan, Emory University School of Medicine, Atlanta, GA, United States; Evan Orenstein, Emory University School of Medicine, Atlanta, GA, United States; Andres Camacho-Gonzalez, Emory University School of Medicine, Atlanta, GA, United States; Mark Griffiths, Emory University School of Medicine, Atlanta, GA, United States; Claudia R.. Morris, Emory University School of Medicine, Atlanta, GA, United States

Background: In July 2023, Children’s Healthcare of Atlanta (Children’s) implemented opt-out HIV testing in its emergency departments (ED) for patients ≥13 years undergoing venipuncture. The Centers for Disease Control and Prevention (CDC) recommends HIV screening for patients ≥13 years; adolescents are the least likely group to know their HIV status. Over the past two years, Children’s HIV testing numbers more than doubled,13 adolescents living with HIV (ALHIV) were identified and 46% were co-infected with other sexually transmitted infections (STIs). STIs are linked to increase risk of contracting or transmitting HIV. In August 2025, a preventative approach was implemented, comprehensive preventative services (CPS), as an additional layer to Children’s opt-out HIV care model.

Objective: The aim is to review the early outcomes of behavioral and biomedical prevention services following ED based HIV screening.

Design/Methods: Children’s electronic medical record (EPIC) identified all adolescents with a negative HIV test but a positive STI result, to offer CPS. The behavioral intervention was a brief phone-based adaptation of the CDC’s Youth Risk Behavior Survey, a nationally recognized assessment tool; the abridge version assessed sexual behaviors. The biomedical intervention was a referral to the adolescent clinic for evaluation and prescription of HIV prevention medication. The data was compared using descriptive statistical methods.

Results: In the past 12 weeks, 140 adolescents in the ED were identified with negative HIV and positive STI results. Only 32 (23%) adolescents had a phone listed and were contacted. A total of 16 (50%) out of 32 completed the behavioral survey, 4 (25%) males and 12 (75%) females with a mean age (± standard deviation) of 17.4 ± 1.4; the most common STI identified was chlamydia, 13 (81%). The mean of reported number of partners in their lifetime was 5.4 ± 5.1, the highest being 20. The average age of initial sexual intercourse was 15.1 ± 1.6 with the youngest being 13. There were 5 (31%) biomedical CPS referrals and 1 attended their appointment.

Conclusion(s): CPS serves as a critical point of prevention, allowing for education and intervention before adolescents are exposed to HIV. Future efforts will focus on strengthening pediatric sexual health screening by systematically capturing adolescent contact information, expanding automated referral pathways to adolescent clinics, and implementing emergency department–based HIV prevention medication prescribing to reduce HIV susceptibility. Focusing on comprehensive STI preventive resources is essential to address this public health crisis.