187. Use of a Sexual Health Survey Risk Score to Predict Chlamydia and Gonorrhea among Adolescents and Young Adults Receiving In-Clinic Primary Care Services

The six-item Sexual Health Survey assesses demographic and behavioral factors related to risks of sexually transmitted infection (STI). Users of an internet-based STI testing program (IWTK.org) complete the Sexual Health Survey before selecting STI testing. Risk scores can be calculated and categorized based on low, medium, and high risk of STI. The aim of this study was to evaluate if the Sexual Health Survey risk categorization and clinical health history were associated with Chlamydia and gonorrhea positivity, among adolescents receiving in-person, primary care services. Participants, aged 14-21 years, were recruited during primary-care healthcare visits and were eligible to participate if they self-reported a history of sexual intercourse and received clinician-ordered STI testing during the healthcare visit. Participants completed a written Sexual Health Survey and a structured interview assessing demographics, STI symptoms, and health history. Electronic medical records were reviewed for results of Chlamydia and gonorrhea testing completed concurrently with the Sexual Health Survey. The Sexual Health Survey assessed age, new or multiple partners in past 90 days, multiple partners currently, history of STI, number of partners in the past 90 days, and condom use. Based on previous use of the risk score, responses to each survey item were assigned points, summed (0-10), and stratified into low (0-4), medium (5-7), and high (8-10) risk groups. STI positivity was defined as positive for Chlamydia, gonorrhea, or both. Chi-square test was used to test differences in proportion of STI positivity between groups. A total of 415 cisgender female (women) and 60 cisgender male (men) participated. The average age was 18.6 years (SD 1.6) for women and 18.3 years (SD 1.8) for men. STI positivity was 16% among women and 7% among men. Among the 115 women categorized as low, 280 categorized as medium, and 20 categorized as high risk, 25%, 29%, and 40% were STI positive, respectively. A higher risk category was not associated with STI positivity (p=NS). Among the 17 men categorized as low, 34 categorized as medium, and 9 categorized as high risk, 24%, 18%, and 56% were STI positive, respectively. A higher risk category was not associated with STI positivity (p=.07). If the age item was excluded from the score calculation, a higher score category was significantly associated with STI positivity in men (p=.02) but not women (p=NS). One individual question “Have you ever been told you had or been treated for a sexually transmitted infection in the past?” was associated with STI positivity in men (p