Sexually transmitted disease screening by United States obstetricians and gynecologists

Hogben, Matthew; Lawrence, Janet S. St.; Kasprzyk, Danuta; Montaño, Daniel; Counts, George W.; McCree, Donna Hubbard; Phillips, William R.; Scharbo-DeHaan, Marianne

doi:10.1016/s0029-7844(02)02167-1

Cited by 17 publications

(6 citation statements)

References 11 publications

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“…Previous studies have documented that one third to one half of primary care clinicians routinely screen men or women for STDs (chlamydia, gonorrhea, syphilis, or HIV) (26,33,38,39). Obstetriciansgynecologists screen nonpregnant women more often than other primary care physicians (39)(40)(41). Community health centers often provide routine HIV testing for pregnant women but less frequently offer routine HIV testing for men and nonpregnant women (42,43).…”

Section: Current Practice On Selected Clinical Services In the Unitedmentioning

confidence: 99%

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

Barrow¹,

Ahmed²,

Bolan³

et al. 2020

MMWR Recomm. Rep.

103

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This report (hereafter referred to as STD QCS) provides CDC recommendations to U.S. health care providers regarding quality clinical services for sexually transmitted diseases (STDs) for primary care and STD specialty care settings. These recommendations complement CDC's Sexually Transmitted Diseases Treatment Guidelines, 2015 (hereafter referred to as the STD Guidelines), a comprehensive, evidence-based reference for prevention, diagnosis, and treatment of STDs. STD QCS differs from the STD Guidelines by specifying operational determinants of quality services in different types of clinical settings, describing on-site treatment and partner services, and indicating when STD-related conditions should be managed through consultation with or referral to a specialist. These recommendations might also help in the development of cliniclevel policies (e.g., standing orders, express visits, specimen panels, and reflex testing) that can facilitate implementation of the STD Guidelines. CDC organized the recommendations for STD QCS into eight sections: 1) sexual history and physical examination, 2) prevention, 3) screening, 4) partner services, 5) evaluation of STD-related conditions, 6) laboratory, 7) treatment, and 8) referral to a specialist for complex STD or STD-related conditions. CDC developed the recommendations by synthesizing relevant, evidence-based guidelines and recommendations issued by other experts; reviewing current practice in the United States; soliciting Delphi ratings by subject matter experts on STD care in primary care and STD specialty care settings; discussing the scientific evidence supporting the proposed recommendations at a consultation meeting of experts and institutional stakeholders held November 20, 2015, in Atlanta, Georgia; conducting peer reviews of draft recommendations and supporting evidence; and discussing draft recommendations and supporting evidence during meetings of the CDC/Health Resources and Services Administration Advisory Committee on HIV, Viral Hepatitis, and STD Prevention and Treatment STD Work Group. These recommendations are intended to help health care providers in primary care or STD specialty care settings offer STD services at their clinical settings and to help the persons seeking care live safer, healthier lives by preventing and treating STDs and related complications.

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Section: Current Practice On Selected Clinical Services In the Unitedmentioning

confidence: 99%

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

Barrow¹,

Ahmed²,

Bolan³

et al. 2020

MMWR Recomm. Rep.

103

View full text Add to dashboard Cite

show abstract

“…Differences in the prevalence of bacterial STDs, screening and testing rates, and the diagnosis-to-treatment ratio between African Americans and other racial/ethnic groups have been documented 1,29–31. Studies suggest that the reasons for these disparities include limited access to care, unacceptable care, inadequate care, and lack of symptom recognition by providers and patients 32,33. Better understanding of these important factors will enhance efforts to improve STD clinical services for African Americans.…”

Section: Clinical Servicesmentioning

confidence: 99%

“…Although primary and secondary syphilis infections have characteristic symptoms, infected individuals may not recognize them 36. Lack of symptom recognition can lead to delay in treatment and may result in further transmission of disease and the development of severe sequelae 32,33,36. Because many disadvantaged African Americans, particularly African American men, have limited access to general healthcare, screening for STDs is a critical means of disease prevention and control.…”

Section: Clinical Servicesmentioning

confidence: 99%

Traditional Sexually Transmitted Disease Prevention and Control Strategies: Tailoring for African American Communities

Barrow¹,

Berkel²,

Brooks³

et al. 2008

Sexually Transmitted Diseases

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African Americans carry the largest disease burden for bacterial sexually transmitted diseases (STDs) in the United States. These infections can have a devastating impact on sexual and reproductive health if they are not diagnosed and treated. Traditionally, public health efforts to prevent and control bacterial STDs have been through surveillance, clinical services, partner management, and behavioral intervention strategies. However, the persistence of disparities in STDs indicates that these strategies are not achieving sufficient impact in African American communities. It may be that factors such as limited access, acceptability, appropriateness, and affordability of services reduce the efficacy of these strategies for African American communities. In this article we describe the STD prevention strategies and highlight the challenges and implications of these strategies in addressing disparities in African American communities.Surveillance, clinical services, partner management, and behavioral interventions have been used to prevent and control bacterial sexually transmitted diseases (STDs)-gonorrhea, chlamydia, and syphilis-in the United States. These traditional strategies, with the exception of clinical services, are routinely funded in part by the Centers for Disease Control and Prevention (CDC) through a program announcement, which provides federal funding to support activities of STD prevention programs in health departments nationwide. Clinical services are an integral part of STD prevention programs. Health department programs generally support public STD clinical services through state and local funds.African Americans carry the largest disease burden for gonorrhea, chlamydia, and syphilis in the United States. 1 These infections can have a devastating impact on sexual and reproductive health if infections are not diagnosed and treated. 2 Although the traditional strategies for STD prevention and control are implemented in all communities, regardless of race or ethnicity, the annual rates of disease among African Americans have remained disparate from other racial and ethnic communities. These strategies as currently applied may be less successful in African American communities than other racial and ethnic communities.STD surveillance includes the monitoring of STDs or their sequelae, pathogen-specific antimicrobial resistance, sexual behaviors, screening, and healthcare quality and coverage. It

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“…5,6 Likewise, reports on the influence of practice guidelines on physician behavior indicate that few studies show strong adherence to guidelines, 7,8 whereas many studies suggest moderate to high levels of nonadherence with recommendations. [9][10][11] Reasons cited for suboptimal adherence to guidelines include lack of resources or awareness and physician disagreement with what constitutes best practice. [12][13][14][15] A variety of other factors also may influence medication prescribing practices.…”

mentioning

confidence: 99%

Impact of Clinical Trial Results on National Trends in α-Blocker Prescribing, 1996-2002

Stafford

Furberg²,

Finkelstein³

et al. 2004

JAMA

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Context Research on factors that influence prescribing patterns and the extent of change produced by clinical trial findings is limited.Objective To examine the changes in prescribing of ␣-blockers for hypertension treatment before and after the April 2000 publication of the unfavorable Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) early termination involving the study's doxazosin mesylate arm. Changes in prescribing were considered in the context of other potential concurrent influences on medication use between 1996 and 2002, including changes in ␣-blocker drug prices, generic conversion, drug promotion, and competition. Design, Setting, and PatientsUsing 2 national pharmaceutical market research reports published by IMS HEALTH, ␣-blocker prescription orders reported in the National Prescription Audit-a random computerized sample of about 20000 of 29000 retail, independent, and mail order pharmacies and mass merchandise and discount houses-and office-based physician ␣-blocker prescribing patterns reported in the National Disease and Therapeutic Index-a random stratified sample of about 3500 physician offices-were tracked.Outcome Measures Trends in physician-reported use of ␣-blockers and ␣-blocker prescribing and dispensing by US pharmacies.Results There were steady increases in ␣-blocker new prescriptions, dispensed prescriptions, and physician drug use from 1996 through 1999. There was a moderate reversal in these trends following ALLHAT early termination and subsequent publications in early 2000. Between 1999 and 2002, new annual ␣-blocker prescription orders declined by 26% (from 5.15 million to 3.79 million), dispensed prescriptions by 22% (from 17.2 million to 13.4 million), and physician-reported drug use by 54% (from 2.26 million to 1.03 million). Other potential influences did not appear to have contributed significantly to this decline although cessation of ␣-blocker marketing may have hastened the decline.Conclusions Modest yet statistically significant declines in the use of doxazosin and other ␣-blockers coincided with the early termination of the ALLHAT doxazosin arm. Although physicians responded to this new evidence, strategies to augment the impact of clinical trials on clinical practice are warranted.

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Sexually transmitted disease screening by United States obstetricians and gynecologists

Cited by 17 publications

References 11 publications

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

Traditional Sexually Transmitted Disease Prevention and Control Strategies: Tailoring for African American Communities

Impact of Clinical Trial Results on National Trends in α-Blocker Prescribing, 1996-2002

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