Understanding Sexually Transmitted Infection Screening and Management in Indiana Community Health Centers

Navale, Shalini; Meyerson, Beth E.; Ohmit, Anita; Gillespie, A

doi:10.1097/olq.0000000000000198

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Obstetricians-gynecologists and family medicine physicians reported using EPT more often than internal medicine physicians (63,64). A survey of community health centers in Indiana reported that 61% told patients with gonorrhea or chlamydia to refer their partner for testing and treatment and 18% always gave medication to patients to distribute to their partners (66). A survey of Federally Qualified Health Centers in New York City reported that 80% provided EPT for chlamydia, of which 47% were by prescription only, 27% by both prescription and dispensed medication, and 6% by dispensed medication only (67).…”

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

“…Furthermore, studies have shown that FQHC growth has tended to occur in pre-existing service markets, urban areas, and locales with lower poverty rates, suggesting the influence of market-driven factors [12,48]. Although FQHCs face a number of challenges, a body of research indicates their positive impact on STI care [13,20,21]. In this study, we found FQHC availability to be associated with higher rates of bacterial STIs, and this association persisted even when considering Medicaid expansion-an important driver of health outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Standards of care at FQHCs are also important considerations. In a large Midwestern FQHC system, CT and NG screening was only provided upon patients' request or when symptoms were present, despite high community infection rates [21]. In another study of urban FQHCs, patients were not routinely asked about sexual health concerns, regardless of their willingness to engage with providers [22].…”

Section: Federal and State Provisions For Sexual Healthcarementioning

confidence: 99%

“…Finally, there is limited research on the impact of FQHCs on STI outcomes. The available research often involves smaller-scale geographic regions and strictly defined subpopulations [20][21][22][23][24]. Of the studies available, none of them has considered the impact of these safety-net providers in the context of an ecological health model.…”

Section: Purpose Of Studymentioning

confidence: 99%

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Examining County-Level Associations between Federally Qualified Health Centers and Sexually Transmitted Infections: A Political Ecology of Health Framework

Williams,

Skrip,

Adams

et al. 2024

Healthcare

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Federally Qualified Health Centers (FQHCs) are the largest providers of healthcare for sexually transmitted infections (STIs) in medically underserved communities in the United States (US). Through the Affordable Care Act (ACA), FQHCs have grown in number, but the impact of this growth on STIs is poorly understood. This ecological study seeks to quantify the association between FQHCs and STI prevalence in all US counties. Variables were described utilizing medians and interquartile ranges, and distributions were compared using Kruskal-Wallis tests. Median rates of chlamydia in counties with high, low, and no FQHCs were 370.3, 422.6, and 242.1 cases per 100,000 population, respectively. Gonorrhea rates were 101.9, 119.7, and 49.9 cases per 100,000 population, respectively. Multivariable linear regression models, adjusted for structural and place-based characteristics (i.e., Medicaid expansion, social vulnerability, metropolitan status, and region), were used to examine county-level associations between FQHCs and STIs. Compared to counties with no FQHCs, counties with a high number of FQHCs had chlamydia rates that were an average of 68.6 per 100,000 population higher (β = 68.6, 95% CI: 45.0, 92.3) and gonorrhea rates that were an average of 25.2 per 100,000 population higher (β = 25.2, 95% CI: 13.2, 37.2). When controlled for salient factors associated with STI risks, greater FQHC availability was associated with greater diagnosis and treatment of STIs. These findings provide empirical support for the utility of a political ecology of health framework and the critical role of FQHCs in confronting the STI epidemic in the US.

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Identifying variations in adherence to the CDC sexually transmitted disease treatment guidelines of Neisseria gonorrhoeae

et al. 2016

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Understanding Sexually Transmitted Infection Screening and Management in Indiana Community Health Centers

Cited by 4 publications

References 7 publications

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

Examining County-Level Associations between Federally Qualified Health Centers and Sexually Transmitted Infections: A Political Ecology of Health Framework

Identifying variations in adherence to the CDC sexually transmitted disease treatment guidelines of Neisseria gonorrhoeae

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