Systematic STI screening in unaccompanied migrant minors: a 6-year experience with urine-based NAAT

Abstract

Abstract Systematic screening for sexually transmitted infections (STI), beyond serology, is not standard in arrival protocols for unaccompanied migrant minors (UMM). In 2020, our center incorporated urine-based nucleic acid amplification tests (NAAT)-based screening into the existing serology-based protocol (HIV, syphilis, hepatitis B/C), and we describe the additional diagnoses of STI identified through NAAT. We conducted a retrospective observational descriptive study (2020–2025) of 226 UMM (99.6% male) in Madrid undergoing serological screening for HIV, syphilis, hepatitis B and C, with additional urine-based multiplex PCR (NAAT) screening for STI. Urine-based NAAT, performed in 163/226 participants (72.1%), identified six positive cases (3.7%, 95% CI 1.4–7.8%) of C. trachomatis , M. genitalium , or Ureaplasma spp. Of these, four patients (2.5%, 95% CI 0.7–6.2%) had actionable infections that were treated. Serology identified no HIV (0/218) or hepatitis C cases (0/212), one syphilis case (0.5%, 95% CI 0.0–2.6%, 1/209), and three chronic hepatitis B cases (1.4%, 95% CI 0.3–3.9%, 3/221). None of the cases had symptoms recorded. Conclusion : Urine NAAT identified six infections (four actionable) not detectable by serology. However, three of eight patients with actionable infections were lost to follow-up, highlighting that the benefit of systematic screening depends on strengthening linkage-to-care alongside testing. What is Known: • Serological screening (HIV, syphilis, hepatitis B/C) is standard in arrival health assessments for unaccompanied migrant minors, but systematic STI screening beyond serology is not routinely protocoled. • Systematic screening is especially valuable in this population, as follow-up is often limited by care fragmentation and transfers between reception centers. What is New: • Urine-based NAAT screening identified additional STI in patients with no symptoms recorded, that were not detectable by serology alone.

The authors' abstract, as published at the source. European Journal of Pediatrics, 2026 · DOI ↗