Incidence of Sexually Transmitted Infections and Pregnancy Among Adolescents Experiencing Sex Trafficking

Whitney Ficker; Lauren Ehrhardt-Humbert; Stacy Reynolds

doi:10.1097/PEC.0000000000003317

Incidence of Sexually Transmitted Infections and Pregnancy Among Adolescents Experiencing Sex Trafficking

Pediatr Emerg Care. 2024 Dec 24. doi: 10.1097/PEC.0000000000003317. Online ahead of print.

Authors

Whitney Ficker, Lauren Ehrhardt-Humbert¹, Stacy Reynolds²

Affiliations

¹ Wake Forest University School of Medicine, Winston-Salem, NC.
² Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Atrium Health Levine Children's Hospital and Carolinas Medical Center, Charlotte, NC.

PMID: 39715358
DOI: 10.1097/PEC.0000000000003317

Abstract

Objective: There is a lack of data regarding the incidence of sexually transmitted infections (STIs) and pregnancy among adolescents experiencing sex trafficking. This study aimed to determine the incidence proportion of STIs and pregnancy among adolescents evaluated for sex trafficking at an urban tertiary children's hospital compared to the community adolescent population.

Methods: This retrospective, cross-sectional study looked at adolescents aged 11 to 21 years experiencing sex trafficking from March 2019 to March 2022. Data were abstracted from the hospital's human trafficking advocacy team database and the electronic medical record (EMR), including demographics, type and setting of trafficking, presenting complaints, and STI and pregnancy test results. Using Fisher's exact test, the incidence of STIs and pregnancy among adolescents experiencing sex trafficking was compared to adolescents in the community using local county health department data.

Results: Fifty-four patients met the eligibility criteria. Females comprised 93% (n = 50) of the group. The average age was 16 years. The racial demographics most represented were African American at 56% (n = 30) and White at 30% (n = 16). History of abuse prior to trafficking was found in 78% (n = 42). Incidence proportions of STIs, compared to county health data, are as follows: 64.8% for Chlamydia trachomatis (CT) versus 7.8% (OR, 22; 95% CI, 12-40), 51.9% for Neisseria gonorrhoeae (GC) versus 2.2% (OR, 47; 95% CI, 26-83), 9.3% for syphilis versus 0.1% (OR, 111; 95% CI, 34-283), and 5.6% for HIV versus 0.1% (OR, 83; 95% CI, 16-261). There was a high individual cumulative incidence of STIs among patients over time, and patients presented with a variety of presenting complaints. The incidence proportion for pregnancy was 11.1% compared to 1.3% (OR, 10; 95% CI, 3-22).

Conclusions: Adolescents experiencing sex trafficking have a significantly higher rate of STIs and pregnancy than the community adolescent population.