Barriers to Bacterial STI Testing of HIV-Infected Men who have Sex with Men Engaged in HIV Primary Care

Details

• Alternative Title:
  Sex Transm Dis
• Personal Author:
  Barbee, Lindley A. ; Dhanireddy, Shireesha ; Tat, Susana A. ; Marrazzo, Jeanne M.
• Description:
  Background
  
  Approximately 15% of HIV-infected MSM engaged in HIV primary care have been diagnosed with an STI in the past year, yet STI testing frequency remains low.
  
  Methods
  
  We sought to quantify STI testing frequencies at a large, urban HIV care clinic, and to identify patient- and provider-related barriers to increased STI testing. We extracted laboratory data in aggregate from the electronic medical record to calculate STI testing frequencies (defined as the number of HIV-infected MSM engaged in care who were tested at least once over an 18-month period divided by the number of MSM engaged in care). We created anonymous surveys of patients and providers to elicit barriers.
  
  Results
  
  Extra-genital gonorrhea and chlamydia testing were low (29%–32%), but the frequency of syphilis testing was higher (72%). Patients frequently reported high-risk behaviors, including drug use (16.4%) and recent bacterial STI (25.5%), as well as substantial rates of recent testing (>60% in prior 6 months). Most (72%) reported testing for STI in HIV primary care, but one-third went elsewhere for “easier” (42%), anonymous (21%) or more frequent (16%) testing. HIV primary care providers lacked testing and treatment knowledge (25–32%), and cited lack of time (68%), discomfort with sexual history taking and genital exam (21%), and patient reluctance (39%) as barriers to increased STI testing.
  
  Conclusion
  
  STI testing in HIV care remains unacceptably low. Enhanced education of providers, along with strategies to decrease provider time and increase patient ease and frequency of STI testing, are needed.
  
  
• Subjects:
  Adult Ambulatory Care Facilities Article Behavioral Risk Factor Surveillance System HIV Seropositivity Homosexuality, Male Humans Male Mass Screening Primary Health Care Sexual Behavior Sexually Transmitted Diseases, Bacterial Sexual Partners Viral Load

  More +
• Source:
  Sex Transm Dis. 42(10):590-594.
• Pubmed ID:
  26372931
• Pubmed Central ID:
  PMC4576720
• Document Type:
  Journal Article
• Funding:
  K23 AI113185/AI/NIAID NIH HHS/United States ; PS1-1103/PS/NCHHSTP CDC HHS/United States ; T32 AI07041/AI/NIAID NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  42
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0db5d5311bead8f0d3fd9024b5aecc2f0a74aa4e30b483783ff53d50a999d676
• Download URL:
  https://stacks.cdc.gov/view/cdc/36195/cdc_36195_DS1.pdf
• File Type:
  [PDF - 167.73 KB ]