Sexually Transmitted Infection Testing of HIV-Positive Medicare and Medicaid Enrollees Falls Short of Guidelines

Landovitz, Raphael J.; Gildner, Jennifer; Leibowitz, Arleen

doi:10.1097/olq.0000000000000695

Cited by 26 publications

(13 citation statements)

References 24 publications

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“…Several studies have suggested that MSM are not screening for bacterial STIs as frequently as recommended. This has been quantified by HIV status, 19 health insurance status, 20 race/ethnicity, 21 and participation in HIV prevention programs. 22 However, most of these studies quantify gaps in testing using period prevalence measures rather than rate-based measures.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Sexually Transmitted Infection Screening Rates by Symptomatic Status Among Men Who Have Sex With Men in the United States: A Hierarchical Bayesian Analysis

Jenness

Weiss²,

Prasad³

et al. 2019

Sexual Trans Dis

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Section: Discussionmentioning

confidence: 99%

Bacterial Sexually Transmitted Infection Screening Rates by Symptomatic Status Among Men Who Have Sex With Men in the United States: A Hierarchical Bayesian Analysis

Jenness

Weiss²,

Prasad³

et al. 2019

Sexual Trans Dis

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show abstract

“…Provider adherence to screening recommendations (Table 1) put out by the CDC, the US Preventive Services Task Force (USPSTF), and the American College of Obstetricians and Gynecologists (ACOG) is crucial to the success of syphilis intervention strategies. Several studies suggest less than adequate provider adherence to STI screening practices; this includes low syphilis testing rates among positive HIV individuals, 50,51 missed opportunities for preventing congenital syphilis cases, 52 and low syphilis testing for females who gave birth to stillborns. 53 Health care systems should look to implement quality control initiatives that monitor provider adherence to syphilis screening, and third party payers should consider implementing reimbursement incentives that reward health systems for better screening practices.…”

Section: Medical Provider's Rolementioning

confidence: 99%

Resurgence of Syphilis in the United States: An Assessment of Contributing Factors

2019

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In the last decade, there has been a marked resurgence of syphilis in the United States despite the availability of effective treatments and previously reliable prevention strategies. The majority of cases are among the population of men who have sex with men (MSM); however, there has also been a recent increase among premenopausal women, coinciding with a concerning rise of congenital cases. The resurgence of syphilis can be largely attributed to changing social and behavioral factors, especially among young MSM. The biological association of syphilis with human immunodeficiency virus (HIV) transmission and acquisition is particularly alarming because of the increased individual and healthcare burden. In addition, some individual actions and public health efforts that are meant to reduce the risk of acquiring HIV may actually lead to risk compensation that facilitates the transmission of syphilis. Untreated syphilis is associated with detrimental health outcomes; therefore, both effective prevention strategies and treatment of this systemic disease have important short-term and long-term public health implications. This article offers a review of social and behavioral factors contributing to the current resurgence and recommendations for reducing syphilis incidence through medical and public health prevention strategies.

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“…Whereas data are lacking in Germany, studies from UK, USA, and Canada suggest that STI testing uptake in HIV cohorts remains suboptimal, especially in MSM [15][16][17][18]. In a multicenter study in several HIV cohorts in USA, annual testing rate for NG/CT was only 39% of patients engaged in care compared to 77% testing rate for syphilis, although most patients reported sexual behavior with a higher possibility for STI transmission [17].…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up after introduction of a systematic sexually transmitted infection screening program for men having sex with men living with HIV in a primary care setting: uptake, STI incidence, and risk factors for infection and reinfection

et al. 2022

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Purpose Annual screening for asymptomatic infections with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) is recommended by international guidelines in people living with HIV but uptake in routine care remains poor. This study analyzed the effects of the implementation of a CT/NG screening program in a primary HIV treatment center. Methods In this single-center cohort study, we included men having sex with men (MSM) living with HIV during the study period from January 2016 to December 2019. From January 2018 on, annual sexual health counseling including CT/NG screening was proactively offered to all MSM presenting at the center. CT/NG screening rates, test positivity rates and case detection rates in the years 2018 and 2019 were compared to those in the years 2016 and 2017. Results A total of 234 patients were enrolled in the study contributing to 798.7 patient years (py) during the four-year study period. Screening rates increased from 3.1% and 3.9% in 2016 and 2017 to 51.1% in 2018 and decrease to 35.4% in 2019. Over the study period, 19.7% (46/234) had at least one positive CT/NG result. After the intervention, case detection per 100 py increased for CT (2016: 2.6, 2017: 3.7, 2018: 7.7, 2019: 7.1) and NG (2016: 3.2, 2017: 3.1, 2018: 5.3, 2019: 7.6). The number needed to test was 8.9 for CT and 10.4 for NG. Conclusion Regular CT/NG screening is feasible in a primary care setting, leads to an increase in case detection and may contribute to decrease transmission and complications of CT/NG. Trial registration The trial is registered in ClinicalTrials.gov (NCT02149004).

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Sexually Transmitted Infection Testing of HIV-Positive Medicare and Medicaid Enrollees Falls Short of Guidelines

Abstract: Sexually transmitted disease rates are rising rapidly among men who have sex with men, yet sexually transmitted disease screening for people living with HIV is well below the Centers for Disease Control and Prevention recommendations, especially for chlamydia and gonorrhea.

Cited by 26 publications

References 24 publications

Bacterial Sexually Transmitted Infection Screening Rates by Symptomatic Status Among Men Who Have Sex With Men in the United States: A Hierarchical Bayesian Analysis

Bacterial Sexually Transmitted Infection Screening Rates by Symptomatic Status Among Men Who Have Sex With Men in the United States: A Hierarchical Bayesian Analysis

Resurgence of Syphilis in the United States: An Assessment of Contributing Factors

Long-term follow-up after introduction of a systematic sexually transmitted infection screening program for men having sex with men living with HIV in a primary care setting: uptake, STI incidence, and risk factors for infection and reinfection

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