A Quality Improvement Project Using Microlearning to Increase Provider Adherence to Extragenital Sexually Transmitted Infection Screening Guidelines in Men Who Have Sex With Men

Abstract

The Centers for Disease Control and Prevention (CDC) recommend screening men who have sex with men who are living with HIV for sexually transmitted infections at appropriate extragenital contact sites for bacterial sexually transmitted infections. In an effort to increase provider adherence to CDC recommended guidelines at a Ryan White Clinic, microlearning educational sessions were used. A quality improvement project was designed to determine the rate of provider adherence to CDC guidelines pre/post microlearning sessions. Student t-test was used to compare the number of patients who received urine and extragenital screening to those who received urine-only screening, to before and after the microlearning sessions. The rate of extragenital screening significantly increased after the microlearning sessions (4/460 vs. 70/507, p , .0001). The rate of urine screening remained unchanged (p 5 1). Although extragenital screening significantly increased, it remained low. A decision tree in the electronic medical record to prompt providers to screen was developed.

Evidence-based sexual healthcare for the LGBTQIA2+ patient across the lifespan

“…50 NPs should obtain comprehensive sexual health and social histories, but many report barriers to comprehensive history completion and appropriately tailored STI screenings such as lack of time during clinic visits. 51 Screening for gonorrhea and chlamydia should occur at least annually for sexually active MSM at the sites of contact (urethra and rectum for chlamydia; urethra, rectum, and pharynx for gonorrhea), regardless of condom use. Screening recommendations should be adapted based on anatomy (for example, the recommendation for annual, routine screening for chlamydia in cisgender women younger than 25 years should be extended to all transgender men and genderdiverse people with a cervix; individuals age 25 years and older with a cervix should be screened if at increased risk).…”

“…NPs should be familiar with the CDC's latest STI guidelines update, released in 2021 50. NPs should obtain comprehensive sexual health and social histories, but many report barriers to comprehensive history completion and appropriately tailored STI screenings such as lack of time during clinic visits 51. Screening for gonorrhea and chlamydia should occur at least annually for sexually active MSM at the sites of contact (urethra and rectum for chlamydia; urethra, rectum, and pharynx for gonorrhea), regardless of condom use.…”