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Background Adolescents account for 1 in 4 sexually transmitted infections (STIs) diagnosed annually in the United States. Many adolescents seek care in emergency departments (ED) for acute medical problems which offers an opportunity to screen for risk behaviors including sexual health. As emergency medicine provider time is focused on the acute medical problem, using technology may be an acceptable and effective alternative to identify and decrease screening risky sexual behaviors. Methods Adolescents aged 13–18 years participated in a randomized controlled trial of an electronic health behavior screening and feedback tool in a pediatric emergency department. All participants were surveyed about risky behaviors at the baseline ED visit and 3 months later, and only intervention arm participants received immediate individualized electronic feedback about their risk behaviors, normative comparisons and brief educational information, including on birth control and condoms. In this secondary analysis, we used Chi-squared analyses to compare differences in 3-month STI risk defined as sexually active and reporting inconsistent condom use. Results A total of 296 adolescents including 55% females enrolled in the study with 72% (n=212) completing the 3 month follow-up survey. At baseline 23% (69/296) reported ever having sex and 67% (46/69) reported using a condom at last sex. At follow-up 16% (17/105) of the intervention group and 23% (25/107) of controls reported having sex in the last 3 months. Of those sexually active, 35% (6/17) of intervention group compared to 56% (14/25) of control group reported not always using condoms in the last 3 months (p=0.19). STI risk at 3 months was 6% (6/105) for intervention participants compared to 13% (14/107) for controls (p=0.07). Conclusion Electronic sexual health screening in the emergency department increases opportunities to assess, identify, and intervene in risky sexual behaviors in adolescents and may contribute to a decrease in risky behaviors. Disclosure No significant relationships.