Sexually Transmitted Infection Clinics as Safety Net Providers

Pathela, Preeti; Klingler, Ellen; Guerry, Sarah; Bernstein, Kyle T.; Kerani, Roxanne P.; Llata, Lisa; Mark, Hayley; Tabidze, Irina; Rietmeijer, Cornelis A.

doi:10.1097/olq.0000000000000255

Cited by 43 publications

(29 citation statements)

References 15 publications

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“…This increase in primary care visits was largely attributable to a rise in the percentage of women seen for STD care (14). Despite these shifts in settings for STD service provision, publicly funded STD clinics continue to serve as a safety net for patients without insurance coverage or other marginalized groups of patients seeking care (15).…”

Section: Introduction Backgroundmentioning

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: Introduction Backgroundmentioning

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

“…Evidence-based guidance is needed to help direct limited STD program resources in the United States, where health care is uniquely structured (e.g., reduced access to care, not a single-payer system, and co-payments for services) and sexual health services are mostly provided in STD and family planning clinic settings. 3,4 Previous reviews of non–clinic-based STD screening activities have not been restricted to settings in the United States; were not inclusive of data from syphilis, chlamydia, and gonorrhea screenings; and have not focused on the programmatic costs of implementation or the cost efficiency of case finding. 5,6 We review recently published reports on the outcomes of non–clinic-based STD screening programs (including corrections, bathhouse, and self-collected specimen home-based screenings).…”

mentioning

confidence: 99%

Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program

Bernstein

Chow

Pathela

et al. 2016

Sexually Transmitted Diseases

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Background The development of noninvasive nucleic acid amplification tests for chlamydia and gonorrhea has facilitated innovation in moving sexually transmitted disease (STD) screening to nonclinical settings. However, limited data are available to inform local STD programs on evidence-based approaches to STD screening in nonclinical settings in the United States. Methods We conducted a systematic review of the literature published since 2000 related to chlamydia, gonorrhea, and syphilis screening in US correctional settings, bathhouses and sex venues, self-collected at-home testing, and other nonclinical sites. Results Sixty-four articles met eligibility criteria and were reviewed. Although data on testing volume and positivity were available, there were scarce data on the proportion of new positives treated and the programmatic costs for the various screening programs. Screening in correctional settings identified a sizable amount of asymptomatic infections. The value and sustainability of screening in the other nonclinical settings examined was not clear from the published literature. Conclusions Local and state health departments should explore the development of sustainable jail and juvenile detention screening programs for STDs. Furthermore, local programs should pilot outreach and home-based STD screening programs to determine if they are identifying asymptomatic persons who would not have otherwise been found. Local programs are encouraged to present and publish their findings related to non–clinic-based screening to enhance the limited body of literature; data on the proportion of new infections treated and the local program costs are needed.

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“…It has been noted 47 that STI clinics, which serve a population that is largely male, are the “new” safety net providers; the current study did not ask about the nature of the clinic, only total clinic visits and it is possible that respondents reported visits to STI clinics differently, depending on their sexual preference. Heterosexual men reported a higher mean number of outpatient clinic visits compared to gay or bisexual men, but it is possible that the heterosexual men were including visits to STI clinics, while gay and bisexual men were not.…”

Section: Discussionmentioning

confidence: 98%

Using the Bem and Klein Grid Scores to Predict Health Services Usage by Men

Reynolds

Fisher

Dyo

et al. 2016

Behavioral Medicine

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We examined the association between scores on the Bem Sex Roles Inventory (BSRI), Klein Sexual Orientation Grid (KSOG) and utilization of hospital inpatient services, emergency departments, and outpatient clinic visits in the past 12 months among 53 men (mean age 39 years). The femininity subscale score on the BSRI, ever having had gonorrhea and age were the three variables identified in a multivariate linear regression significantly predicting use of total health services. This supports the hypothesis that sex roles can assist our understanding of men’s use of health services.

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Sexually Transmitted Infection Clinics as Safety Net Providers

Cited by 43 publications

References 15 publications

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program

Using the Bem and Klein Grid Scores to Predict Health Services Usage by Men

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