TOPLINE

Among adolescent sexual assault survivors treated in a pediatric emergency department (ED), about 75% received guideline-recommended postexposure prophylaxis (PEP) for sexually transmitted infections (STIs), but only about one third of those prescribed outpatient antibiotics completed the full treatment course, highlighting important gaps in postdischarge adherence.

METHODOLOGY

• Researchers conducted a retrospective, single-center, descriptive study at a pediatric ED in Texas, including 459 patients aged 0-17 years (82.1% girls; 44.4% Hispanic or Latino individuals), evaluated between 2022 and 2024. 
• Researchers reviewed demographic characteristics, STI testing results, prophylaxis administration, and prescription practices. STI testing included gonorrhea and chlamydia testing using urine, rectal, and pharyngeal specimens; routine trichomonas testing had not yet been implemented.
• Standardized follow-up telephone calls were conducted with adolescents with positive STI test results who were discharged from the ED to assess whether prescribed medications were filled, started, and completed.
• The outcomes included STI positivity, receipt of recommended prophylaxis, prescription filling, medication initiation, and treatment completion. 

TAKEAWAY

• Genital penetration was more common among adolescents aged 12-17 years (84.7%). 
• Of the 31 adolescent patients with an STI who were discharged, 74.2% received the recommended prophylaxis for gonorrhea, chlamydia, and trichomonas in the ED; however, 19.4% did not receive any trichomonas prophylaxis despite recommendations. 
• Among the adolescents tested, 14.8% tested positive for chlamydia and 5.8% tested positive for gonorrhea, whereas among the 266 patients younger than 12 years, only 1.9% tested positive for chlamydia and none tested positive for gonorrhea.
• Among the 17 adolescents who received ED prescriptions and had known follow-up outcomes, 70.6% filled their prescriptions, 58.8% started their medications, and only 35.3% completed the full course of medication. 

IN PRACTICE

"Prescription fill rates for PEP among pediatric sexual assault survivors in this cohort were suboptimal, suggesting a potential gap in postassault care," the authors wrote.

"This highlights the need for targeted strategies to improve education and medication accessibility. Interventions such as designated follow-up, enhanced trauma-informed training, and standardized discharge protocols may improve adherence to recommended care and ensure at-risk patients receive and complete PEP," they added.

SOURCE

The study was led by Sally Henin, McGovern Medical School, The University of Texas Health Science Center, Houston. It was published online on July 22, 2026, in The American Journal of Emergency Medicine.

LIMITATIONS

The study was limited by its retrospective, single-center design; small number of patients who tested positive for an STI; variable timing of follow-up calls, which may have underestimated treatment completion; inability to determine true medication adherence from prescription fill data; and lack of assessment of prescription adherence among patients who tested negative for an STI.

DISCLOSURES

Funding information was not provided for the study. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.