STD-Prevent: Evaluation of a Provider-based Intervention to Enhance STD Screening of Men Who Have Sex with Men (MSM) in California

Background:
Sexually transmitted diseases (STDs) increase risk for HIV acquisition and transmission, but clinical provider adherence to CDC STD screening guidelines for MSM is inconsistent. It is important to implement interventions to increase HIV-care provider awareness of the need for, and actual practice of, routine STD screening of MSM patients.

Objective:
To evaluate the effectiveness of the toolkit entitled Screen, Test, Diagnose & Prevent: A Clinician's Resource for STDs in Gay Men and Other Men Who Have Sex With Men (STD-Prevent) among HIV-care providers.

Method:
In 2007, STD-Prevent was delivered to 7 HIV-care clinics in California with a high proportion of MSM patients. Providers completed a pre- and 5-month, post-intervention survey to assess their awareness of STD screening guidelines, sexual history-taking and routine screening behaviors, and the usefulness and appropriateness of materials. Laboratory data on STD tests performed pre/post-intervention were also collected.

Result:
14 pre-intervention surveys were completed from 4 of the 7 clinics. At baseline, all respondents had referred to CDC STD Treatment Guidelines in the previous year. Complete sexual histories were reportedly taken at the patient's initial visit over 90% of the time; incomplete histories taken at least half of the time at follow-up visits. All providers reported routinely screening for syphilis; 50% routinely screen for chlamydia and gonorrhea. Laboratory data 3-months pre- and post-intervention revealed increases in the mean number of tests performed per month (syphilis: 27 (11%); gonorrhea/chlamydia 14.7 (29%/28%, respectively)). Preliminary post-intervention results indicate that materials were useful, and sexual history-taking at follow-up visits and routine STD-screening increased. Additional data are being collected.

Conclusion:
Providers were well-informed prior to receiving STD-Prevent, but still found it useful and it may have improved STD-screening rates.

Implications:
Incorporating program evaluation into projects at the outset is useful for establishing baseline effectiveness of interventions and making future improvements.