Background:
Urban Emergency Departments (EDs) serve a diverse client population often at high risk for sexually transmitted infections (STIs).

Objective:
To assess the prevalence and correlates of self-reported STIs among a multi-national urban ED population.

Method:
Between June and August, 2005, all patients and their accompanying guests visiting NYU EDs were asked to complete an in-person, anonymous interview in either English or Spanish. Participants were asked if they had ever been diagnosed with gonorrhea, chlamydia, trichomonas, genital warts, syphilis, herpes, or HIV. These 7 STIs were combined into a dichotomized response signifying diagnosis with any STI. Prevalence and 95% confidence intervals were estimated. Univariate and multivariate correlates of any STI diagnosis were assessed using logistic regression.

Result:
The overall response rate was 77% with 409 respondents completing the interview. Forty-six percent of the respondents were female, over a third were born outside of the United States, and 22% reported having no health insurance. The mean age of respondents was 42.8 years (median 41). A total of 46 (11.2% [95% CI 8.1%-14.3%]) reported a diagnosis of any STI. No differences were seen for self-reported STI with respect to gender or age. Black (OR=3.2), foreign born respondents (OR=2.3), those who had four or more ED visits in the last year (2.3), those who reported their health as fair or poor (OR=2.1) and those with same sex sexual partners (OR=3.6) were statistically significantly more likely to report an STI.

Conclusion:
Although an older population, 11% of urban ED visitors self-reported an STI. Disenfranchised clients (poorer health, more visits to the ED, foreign birth) to the ED were more likely to report a history of an STI.

Implications:
Urban EDs may be a unique health care site for interaction with many individuals, particularly those lacking insurance. Screening for STIs in the population is warranted.