ABCs of Combination Prevention Counseling Postcard

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Improvement of Sexually Transmitted Disease Screening among HIV-Infected Men Who Have Sex with Men Through Implementation of a Standardized Sexual Risk Assessment Tool

Screening for gonorrhea (GC) and chlamydia (CT) and syphilis among HIV-positive (HIV+) men who have sex with men (MSM) is recommended at least annually. However, significant gaps in screening coverage exist. We conducted a quality improvement intervention to determine whether informing providers of preintervention screening rates and routinizing sexual risk assessment would improve sexually transmitted disease (STD) screening in a large HIV care clinic.

In partnership with Kaiser Permanente Northern California, we developed and implemented a 10-item assessment addressing sexual and other behavioral risk factors among HIV+ MSM. We analyzed the proportion of patients screened for GC/CT and syphilis in a preintervention period (June 25-September 26, 2012) and during the intervention period (June 25-September 26, 2013).

Of 364 HIV+ MSM seen for care during the intervention period, 

• 47.3% completed the sexual risk assessment. 

Improvements in GC/CT screening and syphilis screening were observed; when comparing the preintervention period with the intervention period, the proportion of HIV+ MSM receiving GC/CT screening increased 

• by 26.8% at any anatomical site and 
• by 45% at the pharyngeal site. 
• Syphilis screening significantly increased by 18.8%.

Overall STD screening increases were observed after this intervention that included didactic training on the urgency of STD screening needs for HIV+ MSM, a presentation of preintervention clinic STD screening data, and the implementation of self-reported sexual risk assessment. Additional efforts are needed to determine feasible ways to accurately assess the appropriateness of STD screening and success of interventions to improve STD screening.

Via:  http://ht.ly/SlVX1 

By: Scarborough AP1, Slome S, Hurley LB, Park IU.

• 1From the *California STD/HIV Prevention Training Center, University of California San Francisco, San Francisco, CA; †The Permanente Medical Group, Oakland, CA; ‡Kaiser Permanente Northern California Division of Research, Oakland, CA; and §Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA.
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