Increased STD testing among sexually active persons receiving medical care for HIV infection in the United States, 2009 – 2013

Abstract

Background Current guidelines recommend that all sexually active HIV-infected persons be tested at least annually for syphilis, chlamydia, and gonorrhea. We examined temporal trends in syphilis, chlamydia, and gonorrhea testing among sexually active HIV-infected adults receiving medical care in the United States during 2009–2013. Methods Using medical record data from the Medical Monitoring Project, a population-based HIV surveillance system, we assessed the proportion of adults in HIV medical care who were tested for syphilis, chlamydia, and gonorrhea in the past 12 months by year and stratified by sex and sexual behavior, age, and race/ethnicity. Results During 2009–2013, the proportion of sexually active HIV-infected adults in medical care who were tested in the past year for all three examined STDs increased from 20% to 36% (PTREND < 0.01). Overall testing for syphilis increased from 55% to 65% (PTREND < 0.01), and significant increases were noted for the following subgroups: MSM (58% to 69%), non-Hispanic whites (48% to 64%), and all age groups with the exception of 18–29 year olds. Overall testing for chlamydia and gonorrhea increased from 22% to 42% (PTREND < 0.01) and significant increases were noted for most sub-groups. Conclusions STD testing significantly increased among sexually active HIV-infected adults receiving medical care; however, the majority of persons were not tested for all three STDs in 2013. While increased testing indicates progress, testing remained far below recommended guidelines. Our findings suggest enhanced efforts may be warranted to screen all sexually active HIV-infected adults for syphilis, chlamydia, and gonorrhea.

Erectile Dysfunction Medication Prescription: STI and Risk Behavior in Men with HIV

“…One VA-based study documented minimal STI testing in the period after EDM prescription. [16] Chlamydia and gonorrhea screening rates were around 40% in a large cohort of HIV-infected adults in the US in 2013 [33] Our study is aligned with these findings which reflect inadequate STI screening rates in high risk groups despite access to care. Syphilis screening rates in the current study were higher than CT/GC (60% before and after EDM).…”

Incidence of syphilis among HIV-infected men in Singapore, 2006–2017: temporal trends and associated risk factors

“…The reasons for the resurgence of syphilis are likely to be multifactorial. Possible factors contributing to the rise in syphilis seroconversion include increased awareness of STIs and the need for testing,15 and the availability of effective HIV antiretroviral treatment16 and pre-exposure prophylaxis leading to changes in risk perception and hence changes in sexual behaviour 17. As per the treatment guidelines for STIs published by the US Centers for Disease Control and Prevention and the European AIDS Clinical Society, HIV-infected individuals are recommended to undergo syphilis testing at least once a year 18 19.…”

Use of national standards to monitor HIV care and treatment in a high prevalence city—Washington, DC

“…In contrast, our estimates for routine screening for STIs were much lower compared to our higher rates of care continuity, ARV prescription, and viral suppression. The DC Cohort estimate for routine screening of gonorrhea (NG) and chlamydia (CT) were lower than combined testing estimates of NG/CT observed in other HIV clinical cohorts (26% and 31% versus 39–42% in other cohorts) [ 27 , 28 ]. Similarly, the DC Cohort screening estimate for syphilis was lower than other HIV cohorts of persons in care (51% versus 65%) [ 28 ].…”

“…The DC Cohort estimate for routine screening of gonorrhea (NG) and chlamydia (CT) were lower than combined testing estimates of NG/CT observed in other HIV clinical cohorts (26% and 31% versus 39–42% in other cohorts) [ 27 , 28 ]. Similarly, the DC Cohort screening estimate for syphilis was lower than other HIV cohorts of persons in care (51% versus 65%) [ 28 ]. Given the recent increases in syphilis, gonorrhea, and chlamydia rates observed among PLWHA, particularly MSM, providers need to be reminded of the importance of secondary prevention and routine sexually transmitted disease screening among PLWHA [ 27 – 31 ].…”