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STI/HIV Testing and Prevalence of Gonorrhea and Chlamydia Among Persons with Their Specified-Type Sex Partner

  • Chirag G. Patel
    Correspondence
    Requests for reprints should be addressed to Chirag G. Patel, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS-E80, Atlanta, GA, 30316.
    Affiliations
    Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Ga
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  • Guoyu Tao
    Affiliations
    Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Ga

    OptumLabs Visiting Fellow, OptumLabs, Eden Prairie, Minn
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Published:October 13, 2021DOI:https://doi.org/10.1016/j.amjmed.2021.09.008

      Abstract

      Background

      Previous studies have shown that sexually transmitted infections (STI) and human immunodeficiency virus (HIV) testing has varied, but STI prevalence was not estimated among patients during their health care visits in which a high-risk sexual partnership was documented. This study estimated gonorrhea, chlamydia, syphilis, and HIV testing rates and chlamydia and gonorrhea prevalence.

      Methods

      From the de-identified commercial claims data of OptumLabs Data Warehouse, we identified men and women aged 15-60 years classified as having high-risk sexual relationships as diagnosis codes: Z72.51 for opposite-sex, Z72.52 for same-sex, and Z72.53 for same-and-opposite-sex relationships, stratified by gender, age group, region, type of health plan, and HIV status. We estimated STI testing rate and prevalence for chlamydia and gonorrhea among patients with high-risk sexual relationships. HIV testing was assessed only in high-risk sexual relationship patients without HIV.

      Results

      Among 8.2 million females and 7.3 million males aged 15-60 years in the database from 2016 to 2019, 115,884 patients (0.7% of female, 0.8% of male) including 3,535 patients with HIV were diagnosed with high-risk sexual relationships. The testing rates for gonorrhea, chlamydia, syphilis, and HIV were 69.4% (confidence interval [CI]: 69.1-69.7), 68.9% (CI: 68.6-69.2), 43.4% (CI: 43.1-43.7), and 41.7% (CI: 41.4-42.0), respectively. Among patients with valid chlamydia and gonorrhea tests, 7.2% (CI: 7.0-7.5) and 2.6% (CI: 2.4-2.8) had positive chlamydia and gonorrhea test results, respectively, and varied by type of high-risk sexual relationship.

      Conclusions

      Our study findings of suboptimal STI screening among patient in high-risk sexual relationships are consistent with previous studies. Administrative records confirmed by lab results indicate a need for STI counseling, testing, and treatment among patients who are diagnosed with high-risk sexual relationships with same-sex, opposite-sex, or same-and-opposite sex partners.

      Keywords

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