Sexual risk behaviors among teens at an urban emergency department: Relationship with violent behaviors and substance use

Purpose: Data regarding sexual risk behaviors among adolescent patients presenting to urban emergency departments (EDs) are lacking. This article describes rates and correlates of sexual risk behaviors among adolescents screened in an urban ED. Methods: During a period of 1-year, a total of 1,576 patients aged 14-18 years, self-administered a computerized survey (57.6% female, 59.3% African American). Results: Among sexually active adolescents (60%), 12% reported four or more partners; of those, 45.3% reported using a condom all the time and 14.7% reported using substances before sex. Regression analyses examined correlates of sexual risk behaviors on the basis of demographics, violence, and substance use. Males and younger teens were more likely to report condom use than females and older teens. Participants with poor grades were more likely to have had sex and used substances before sex, and were less likely to report condom use. Participants reporting dating violence were more likely to have had sex and less likely to have used condoms, whereas participants reporting peer violence and weapon carriage were more likely to report substance use before sex. Binge drinking and marijuana use were associated with all sex risk behaviors. Conclusions: The visit to an urban ED may provide an opportunity to deliver interventions to address sexual risk behaviors among adolescents.