P46 Pilot Study of Sexual History Taking and Sexually Transmitted Infection Screening in Patients Initiating Erectile Dysfunction Medication Therapy

Wednesday, March 14, 2012
Hyatt Exhibit Hall
Katherine M. Holman, MD, Division of Infectious Diseases Department of Medicine, 1Birmingham VA Medical Center 2University of Alabama at Birmingham, Birmingham, AL, J. Andrew Carr, PharmD, BCPS, Department of Pharmacy, Birmingham VA Medical Center, Birmingham, AL, John W. Baddley, MD, MSPH, Division of Infectious Diseases, Department of Medicine, Birmingham VA Medical Center, University of Alabama at Birmingham, BIrmingham, AL and Edward W. Hook III, MD, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL

Background: Erectile dysfunction (ED) remains an important aspect of medical care, with up to 20-50% of adult men affected. The FDA approved sildenafil in 1998 providing a non-invasive, effective therapy for ED, which quickly became widely used. This has led to concerns of possible increased sexual risk taking and sexually transmitted infections (STIs).

Objectives: We evaluated sexual history taking and STI screening in a population of Veterans receiving an initial ED medication prescription in an outpatient setting.

Methods: Utilizing a standardized data extraction tool, charts of patients were reviewed. Patient and clinic demographics were determined, along with rates of sexual history taking and STI screening and diagnoses.

Results: 252 patients who received initial ED therapy from October 1st-December 31st, 2009 were identified and included in the analysis. Overall, approximately 3% of patients were asked any aspect of a sexual history in the 24 months surrounding initial ED medication prescription. STI screening was 9.9% for syphilis, 4.8% for HIV, and 4.3% for gonorrhea/chlamydia prior to prescription, with only a slight increase in HIV screening after. Four incident STIs were found; however, two represented diagnosis rather than from screening.

Conclusions: Little sexual history taking and STI screening were identified in a cohort of Veterans during the 24 months surrounding a new ED medication prescription. Only four incident STIs were found.

Implications for Programs, Policy, and Research: Determining provider and patient barriers to discussion of sexual health, as well as STI screening, in patients seeking treatment for ED is a research priority.