Sexually Transmitted Infections (STI) in Adolescents Clinical Pathway — Emergency Department and Primary Care

Review Testing and Results Communication Plan with Adolescent

Review testing to be completed during the visit, obtain assent/consent.

Obtain the following information during a private interview with adolescents ≥ 13 yrs of age to clarify route of communication around test results.

Emergency Department	STI Order set requires documentation of: Adolescent's cell phone number For adolescents ≥ 13 yrs: Consent to receive text message Consent for parental notification of STI result Empiric treatment offered, given Ensure texting is completed via CHOP-approved system for confidentiality Discuss option of Expedited Partner Therapy (EPT)
Primary Care	Consider documenting the following: Adolescent's cell phone number Adolescent's email address as backup Adolescents' consent for parental notification of STI result Empiric treatment given For participating offices: Adolescents ≥ 13 yrs consent to receive text message Ensure texting is completed via CHOP-approved system for confidentiality

Emergency Department

STI Order set requires documentation of:
- Adolescent's cell phone number
- For adolescents ≥ 13 yrs:
  - Consent to receive text message
  - Consent for parental notification of STI result
- Empiric treatment offered, given
- Ensure texting is completed via CHOP-approved system for confidentiality
- Discuss option of Expedited Partner Therapy (EPT)

Primary Care

Consider documenting the following:
- Adolescent's cell phone number
- Adolescent's email address as backup
- Adolescents' consent for parental notification of STI result
- Empiric treatment given

For participating offices:
- Adolescents ≥ 13 yrs consent to receive text message
- Ensure texting is completed via CHOP-approved system for confidentiality

Communicating STI Test Results

Emergency Department	Positive STI Test Results Adolescent will be contacted to review results, using above methods Prescriptions provided as needed if adolescent not treated No communication for negative results except for HIV
Primary Care	Positive STI Adolescent will be contacted to review results Provide prescription, appointment as needed

Adolescent Untreated

Adolescents that are untreated whose tests were sent from the ED or primary care, the laboratory will report positive cases to the Department of Public Health.
Follow-up with adolescents for positive test results occurs through standard operating procedures for ED APP or Primary Care follow-up.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.