scholarly journals Opt-out Testing Pilot for Sexually Transmitted Infections Among Immigrant Detainees at 2 Immigration and Customs Enforcement Health Service Corps–Staffed Detention Facilities, 2018

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 82S-89S
Author(s):  
Edith Lederman ◽  
Andria Blackwell ◽  
Gina Tomkus ◽  
Misty Rios ◽  
Brent Stephen ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Staff Member ◽  
Screening Program ◽  
Sexually Transmitted ◽  
Staff Members ◽  
Sti Testing ◽  
Opt Out ◽  
Correctional Settings ◽  
Immigration And Customs Enforcement ◽  
Detention Facilities

Objectives Correctional settings (prisons, jails, detention facilities) provide a unique opportunity to screen for sexually transmitted infections (STIs) among correctional populations with a high prevalence of infection. Immigrant detainees are a distinct and poorly described correctional population. The main objective of this study was to determine the feasibility of a national STI screening program for immigrant detainees. Methods and Materials We developed an opt-out STI testing program that included electronic health record integration, patient education, and staff member training. We piloted this program from June 22 through August 19, 2018, at 2 detention facilities with different operational requirements and detainee demographic characteristics. We assessed STI test positivity rates, treatment outcomes, estimated cost to conduct testing and counseling, and staff member perceptions of program value and challenges to implementation. Results Of 1041 immigrant detainees approached for testing, 526 (50.5%) declined. Of 494 detainees who were tested, 42 (8.5%) tested positive for at least 1 STI; the percentage positivity rates were 6.7% (n = 33) for chlamydia, 0.8% (n = 4) for syphilis, 0.8% (n = 4) for gonorrhea, 0.6% (n = 3) for hepatitis B, and 0.2% (n = 1) for HIV. The estimated cost to detect any STI ranged from $500 to $961; the estimated cost to identify 1 person infected with HIV ranged from $22 497 to $43 244. Forty of 42 persons who tested positive began treatment before release from custody. Medical staff members had positive views of the program but had concerns about workload. Practice Implications STIs are prevalent among immigrant detainees. A routine screening program is feasible if operational aspects are carefully considered and would provide counseling, education, and treatment for this vulnerable population.

scholarly journals STI initiative: Improving testing for sexually transmitted infections in women

2018 ◽  
Vol 7 (4) ◽  
pp. e000461 ◽  
Author(s):  
Ryan Christopher Chadwick ◽  
Kathleen McGregor ◽  
Paula Sneath ◽  
Joshua Rempel ◽  
Betty Li Qun He ◽  
...  
Keyword(s):  
Health Care ◽  
Sexually Transmitted Infections ◽  
Economic Cost ◽  
Incidence Rates ◽  
Nucleic Acid Amplification ◽  
Urgent Care ◽  
Quality Improvement Initiative ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Opt Out

Canadian urgent care and walk-in medical clinics provide health care for a population that may be poorly covered by traditional health care structures. Despite evidence suggesting that women with urinary complaints experience a high incidence of sexually transmitted infections (STIs), this population may be under-tested in this particular setting. The aim of this quality improvement initiative was to increase STI testing in women presenting with GU complaints. Implementation of an opt-out method of STI testing for women ages 16 and older was introduced at three walk-in clinics. Women presenting with GU complaints were given the opportunity to provide samples for both conventional urine culture and nucleic acid amplification testing (NAAT) for non-viral STIs. Patients received treatment according to standard of care and public health was notified as per local regulations. Testing rate and STI incidence was tracked via clinic electronic medical records (EMRs). Overall results were tracked using run charts and compared to historical data for the year prior to the start of the project. Over a 1 year period prior to this intervention, only 65 STI tests were performed in over 1100 GU complaints (5.5%). Six STIs were identified during this time. During the 36-week project period, testing increased to 45% of the patient population (320/707). The STI detected incidence increased from 0.51% to 1.4% in all women, and from 0.84% to 3.4% in women aged 16–29 years. An opt-out method was an effective intervention for increasing STI testing within the walk-in clinic setting. With optimisation, significant increases in testing rates can be obtained without substantially increasing clinic workload and at no economic cost to the clinic. As expected, detected incidence rates of STIs were higher than the recognised population prevalence.

Acceptability and feasibility of screening pregnant women for sexually transmitted infections in Rawalpindi, Pakistan

2021 ◽  
pp. 095646242110076
Author(s):  
Ameen E Chaudry ◽  
Rizwana Chaudhri ◽  
Aasia Kayani ◽  
Lamar W Hayes ◽  
Claire C Bristow ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted Infection ◽  
Trichomonas Vaginalis ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Sexual Histories

Objectives: To understand the acceptability and feasibility of sexually transmitted infection (STI) testing during antenatal care, along with the prevalence of STIs, in Rawalpindi, Pakistan. Methods: We enrolled pregnant women seeking antenatal care and performed STI testing using Cepheid GeneXpert® CT/NG and TV kits and Alere Determine™ HIV and syphilis tests. We used interviewer-administered surveys to collect medical, social, and sexual histories. Participants testing positive for STIs and their partners were treated. Results: We enrolled 1001 women from September to December 2019. Nearly all women offered to participate in this study enrolled. Most women understood the effects an STI can have on their pregnancy (99.6%) and valued STI screening during pregnancy (98.1%). 11 women tested positive for any STI: ( Chlamydia trachomatis = 4, Neisseria gonorrhoeae = 1, and Trichomonas vaginalis = 6). Of those, six presented for a test-of-cure, and two were positive for Trichomonas vaginalis. None tested positive for HIV infection or syphilis ( n = 503). Conclusions: STI testing during antenatal care in Rawalpindi was acceptable, valued, understood, and feasible. The prevalence of STIs in pregnant women was low. Continued prevalence monitoring is warranted.

scholarly journals 168. Testing, Diagnosis, and Incidence of Sexually Transmitted Infections Among People with Substance Use Disorders in the Veterans Health Administration, 2019

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S101-S101
Author(s):  
Holly Villamagna ◽  
Lauren Beste ◽  
Joleen Borgerding ◽  
Elliott Lowy ◽  
Ronald Hauser ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexually Transmitted Infections ◽  
Substance Use Disorders ◽  
Veterans Health Administration ◽  
Incidence Rates ◽  
Veterans Health ◽  
Health Administration ◽  
Sexually Transmitted ◽  
Stimulant Use ◽  
Sti Testing

Abstract Background People with substance use disorders (SUDs) are at increased risk of acquiring sexually transmitted infections (STIs.) In response to the syndemic of STIs and SUDs, the Department of Health and Human Services’ 2020 STI National Strategic Plan called for increased STI testing among people with SUDs and integration of testing and treatment into non-traditional settings. Existing data describing STI testing and incidence rates among people with SUDs are limited to single or regional medical centers. National samples are needed to target interventions. We report on STI testing, test positivity, and incidence rates among people with SUDs who receive medical care in the Veterans Health Administration (VHA). Methods We performed a retrospective cohort study of individuals with SUDs who received VHA care in 2018 or 2019. Data were obtained from the Corporate Data Warehouse, a national database that includes data from VHA’s electronic medical record. For individuals with alcohol, opioid, cocaine, and/or other stimulant (e.g. methamphetamine) use disorders, we collected demographic data, testing and results for gonorrhea (GC), chlamydia (CT), syphilis, and HIV during 2019. We calculated rates of testing, test positivity, and incidence rates. Results Incidence of all four STIs was highest in the other stimulant use disorder group; incidence of syphilis was particularly elevated at 922.4 cases/100K. Veterans with multiple SUDs were three times more likely to be houseless in 2019 than those with a single SUD and had higher incidence of all STIs than those with single SUDs, except for people with other stimulant use disorders. People with alcohol use disorder (AUD) had a higher incidence of GC, CT, and syphilis than those with opioid use disorder despite similar testing rates. Percent positivity for HIV ranged from 0.27% for AUD to 2.0% for other stimulant use disorders. Conclusion High incidence of STIs among people with non-cocaine stimulant use disorder indicates a need for comprehensive testing. The data suggests that veterans with AUD would benefit from increased testing. Houselessness and mental health diagnoses were common, and comprehensive STI testing and treatment programs, including an assessment of HIV risk, should be integrated into programs addressing these comorbidities. Disclosures Holly Villamagna, MD, Nothing to disclose

Dysmenorrhea

2021 ◽  
Keyword(s):  
Physical Examination ◽  
Sexually Transmitted Infections ◽  
School Absenteeism ◽  
Imaging Studies ◽  
Endometrial Polyps ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Key Points ◽  
Secondary Dysmenorrhea ◽  
Careful History

Key Points Dysmenorrhea (ie, painful menses) is a frequent cause of school absenteeism in girls.Primary dysmenorrhea typically occurs 1 to 2 years after menarche.Common causes of secondary dysmenorrhea including sexually transmitted infections (STIs), pelvic inflammatory disease, endometriosis, outflow tract obstruction, and endometrial polyps or fibroids.A careful history and physical examination are sufficient to diagnose primary dysmenorrhea.Secondary dysmenorrhea may require additional evaluation, including STI testing, imaging studies, and referral to a specialist.

scholarly journals 433. Implementation of an Emergency Department Syphilis Screening Program

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S216-S216
Author(s):  
Tasleem Chechi ◽  
Allyson C Sage ◽  
Nam Tran ◽  
Sarah Waldman ◽  
Larissa S May
Keyword(s):  
Best Practice ◽  
Congenital Syphilis ◽  
Screening Program ◽  
Turnaround Time ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Increased Risk ◽  
High Prevalence ◽  
Syphilis Screening

Abstract Background Syphilis incidence across all regions of California increased by 22% compared with 2016 cases; with the largest number of chlamydia, gonorrhea, syphilis, and congenital syphilis cases among all states (CDC 2017). The USPSTF recommends targeted syphilis screening in patients at increased risk. However, in emergency departments (EDs) targeted syphilis screening is not routinely performed even when patients present for concerns of a sexually transmitted infection (STI). The purpose of this program was to implement routine syphilis screening among ED patients being tested for chlamydia and gonorrhea (CT/GC) through the use of an EHR enhancement to maximize the number of new syphilis diagnoses. Methods From November 27, 2018 to March 31, 2019, EHR-based syphilis screening was implemented in a quaternary care ED in Northern California serving urban and rural populations. EMR best practice alerts (BPA) were developed and populated on patients receiving STI testing. Syphilis testing employed a reverse sequence algorithm, which is suggested for high prevalence settings and provides rapid turnaround time. Patients were excluded if they opted out from testing. We determined the proportion of all CT/GC tested patients who underwent syphilis screening and the prevalence of syphilis among this group. Results During a four-month period, 649 ED patients with suspected STI received a BPA to screen for syphilis. Of those, 425 patients (65.5%) were screened for syphilis, 22 had a reactive IgG/IgM and RPR, while 5 patients had a reactive IgG/IgM and a nonreactive RPR which required a TPPA test to detect their infection. Fourteen of the 22 patients with a reactive RPR had titers of 1:32 or higher. Nine (32%) of those with a positive CT/GC test tested positive for syphilis. Conclusion Implementation of a syphilis screening program in patients undergoing testing for other STIs yielded 28 new diagnoses compared with those tested prior to the screening in 2018. Introducing an automated EMR-based syphilis screening program is an effective method to maximize syphilis screening in all ED patients seeking treatment for STIs. The screening data suggest that the majority of patients undergoing STI testing in our ED are not screened for syphilis, yet the prevalence of infection in those screened is substantial. Disclosures All authors: No reported disclosures.

scholarly journals Hot, horny and healthy—online intervention to incentivize HIV and sexually transmitted infections (STI) testing among young Mexican MSM: a feasibility study

mHealth ◽  
2020 ◽  
Vol 6 ◽  
pp. 28-28
Author(s):  
Zafiro Andrade-Romo ◽  
Laura Chavira-Razo ◽  
Raluca Buzdugan ◽  
Elena Bertozzi ◽  
Sergio Bautista-Arredondo
Keyword(s):  
Sexually Transmitted Infections ◽  
Feasibility Study ◽  
Online Intervention ◽  
Sexually Transmitted ◽  
Sti Testing

Comparison of Opt-In Versus Opt-Out Testing for Sexually Transmitted Infections Among Inmates in a County Jail

2015 ◽  
Vol 21 (4) ◽  
pp. 408-416 ◽  
Author(s):  
Raees A. Shaikh ◽  
Kari A. Simonsen ◽  
Anne O’Keefe ◽  
Mary Earley ◽  
Mark Foxall ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
County Jail ◽  
Sexually Transmitted ◽  
Opt Out

scholarly journals Barriers to Testing for Sexually Transmitted Infections among HIV-Serodiscordant Couples: The Influence of Discrimination

2020 ◽  
Vol 30 (2) ◽  
pp. 261-268 ◽  
Author(s):  
Jenna Alarcon ◽  
Tamra B. Loeb ◽  
Alison B. Hamilton ◽  
Nicholas J. Moss ◽  
Condessa M. Curley ◽  
...  
Keyword(s):  
Los Angeles ◽  
Sexually Transmitted Infections ◽  
African American Women ◽  
Baseline Survey ◽  
Care Utilization ◽  
Hiv Positive ◽  
Health Seeking ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
The Impact

Objectives: African Americans face chal­lenges in accessing services for sexually transmitted infections (STIs). From 2012- 2016, the EBAN II intervention was funded by the NIH to test the effectiveness of implementing a culturally congruent, evidence-based HIV/AIDS prevention program in Los Angeles and Oakland, California. This study examined the impact of personal characteristics and experiences of discrimination on the likelihood of being tested for STIs.Method: Participants (N=91) completed a baseline survey. Descriptive statistics were used to test for differences between those who did and did not obtain STI testing. Factors included HIV serostatus, sociodemo­graphic variables, STI history, the presence of outside partners, and discrimination ex­periences. Multiple logistic regressions were conducted for men and women separately.Results: Participants with no recent experi­ences of discrimination were more than 3 (3.4) times more likely to obtain a baseline STI test than those who reported discrimina­tion experiences. HIV-positive women with no recent experiences of discrimination were 11 times more likely than those with reports of recent discrimination to obtain STI tests.Conclusions: It is often women who are the gatekeepers for health seeking in families and the same may be for these couples. Ex­periences of discrimination may impede STI testing, and heighten several health risks, particularly among HIV-positive African American women in HIV-serodiscordant relationships. Addressing the impact of dis­crimination experiences may be important for STI prevention and treatment efforts in interventions promoting health care utilization. Ethn Dis. 2020;30(2):261-268; doi:10.18865/ed.30.2.261 

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