Risk factors and associations for the diagnosis of sexually transmitted infections in Aboriginal women presenting to the Alice Springs Hospital emergency department

Objective: To identify risk factors and associations for sexually transmitted infections (STI) in young Aboriginal women presenting to an ED for non-genitourinary reasons, in order to better target opportunistic screening in this group. To determine the prevalence of chlamydia and gonorrhoea in women presenting to the Alice Springs Hospital ED. Methods: A cross-sectional study involving STI screening and participant interview between January 2007 and September 2007 was used. The participants were a convenience sample of Aboriginal women aged 16-35 years presenting to the Alice Springs Hospital ED for non-genitourinary reasons. The main outcome measures were the prevalence of gonorrhoea and chlamydia and significant associations for STI. Results: A total of 213 women were included in the study. The prevalence rates of women screened were 8.9% for chlamydia, 9.4% for gonorrhoea and 16.0% for gonorrhoea or chlamydia. Identified objective associations for positive STI diagnosis included presenting with an injury due to an assault (odds ratio [OR], 3.56), self-reported past history of an STI (OR, 2.53) and leucocytes on urinalysis (OR, 2.19). Conclusion: The prevalence of STI is high in young Aboriginal women presenting to Alice Springs Hospital ED. Screening is acceptable to these patients using low vaginal swabs, and may be targeted at those women with the identified associations. The results of the present study may have relevance to other hospital ED in areas with a high prevalence of STI. A prospective study is needed to confirm these findings.