Study backs four-step plan to detect more sexually transmitted infections

A Rutgers-led study of nearly 1,350 patients receiving HIV care at nine different US clinics identified steps healthcare teams can take to identify and treat more sexually transmitted infections (STIs):

  • Audio Computer-Assisted Self-Interview (ACASI) sex histories at each routine clinic visit
  • Patient self-collection of genital, throat and rectal specimens for gonorrhea and chlamydia
  • Clinical staff training (four virtual sessions for all team members)
  • A dozen sexual and gender minority (LGBTQ+) welcome signs in the clinic environment

The 1,348 participants in the study, published in AIDS Patient Care and STDs, completed 2,203 tablet-based ACASI sexual history surveys, resulting in 531 participants being tested for STIs linked to risky behaviors reported. These tests identified 255 cases of gonorrhea, chlamydia or syphilis, most of which (86%) would otherwise have gone undetected without symptoms, as most clinics only test after annual screenings or when patients are symptomatic.

“It is important to identify and treat these infections because they can have serious long-term consequences such as infertility, blindness and chronic pain, but we have struggled to systematically screen and test those at risk. nationwide,” said John A. Nelson. , lead author of the study and director of national training at the School of Nursing François-Xavier Bagnoud Center in Newark. “Few people realize how common STIs have become. Additionally, providers and patients generally feel uncomfortable discussing sexual behavior, even in HIV clinics.

The incidence of bacterial STIs (chlamydia, gonorrhea and syphilis) has risen sharply since 2014. With more people living with HIV on treatment, virally suppressed and therefore unable to spread HIV, and more people using HIV prevention drugs HIV (PrEP), there has been an increase in sex without a condom.

Using federal recommendations to ask about sexual behaviors and test at-risk or symptomatic patients during routine physician visits and repeat every 3-6 months if risk persists, this evaluative study used the four evidence-based interventions in nine HIV clinics in areas with above-average incidence of HIV and STIs.

According to surveys completed by patients after each clinic visit, more than 93% of participants reported using the ACASI sex history as “easy” or “very easy.” LGBTQ+ welcoming measures were significantly more likely to be noticed and appreciated by those under 50 and by those who identified as LGBTQ+.

“Overall, we were very pleased with the results,” Nelson said. “The procedures detected a significant number of infections and patients reported general satisfaction. The next step will likely be to make these interventions cheaper and easier for providers. Existing costs, primarily additional time for clinical team members to treat STIs, and purchases of ACASI and tablets, were reasonable given the number of STIs detected, but we see opportunities to return them to both cheaper and easier, which will increase provider purchases. moving forward.

Healthcare providers can order a free “starter kit” of interventions for their clinics here.

/Public release. This material from the original organization/authors may be ad hoc in nature, edited for clarity, style and length. The views and opinions expressed are those of the author or authors. See in full here.

Comments are closed.