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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Article Info
Publication History
Published online: October 13, 2021
Footnotes
Funding: None.
Conflicts of Interest: None. The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Authorship: Both authors had access to the data and a role in writing this manuscript.
Identification
Copyright
Published by Elsevier Inc.
