STD Diagnosis and Management Practices in Federally Qualified Health Center Clinics in New York City, 2012

Background: As millions of Americans gain health coverage under the Affordable Care Act, Federally Qualified Health Center (FQHC) clinics are expected to provide healthcare, including STD services, to a larger number of patients. There have been few evaluations of STD practices in these clinics. We describe a survey of FQHC clinics in New York City (NYC).

Methods: A survey was conducted using a convenience sample of 72 FQHC clinics in NYC in 2012. Data were analyzed using SASv9.3.

Results: Of clinics contacted, 51 (70%) completed the survey. Together, they had approximately 1,000,000 patient visits per year. Almost all (98%) used an electronic health record (EHR). More than half conducted anorectal or oropharyngeal nucleic acid amplification tests (NAATs) for gonorrhea (59%) and chlamydia (56%). Most (92%) reported women with chlamydia or gonorrhea were rescreened 3-4 months after treatment. Most encouraged patients to bring partners to clinic for diagnosis and treatment (chlamydia 88%, gonorrhea 90%, syphilis 84%), and 80% provided expedited partner therapy (EPT) for chlamydia. Few reported active involvement of staff in partner notification; provider partner contact was rare (chlamydia 6%, gonorrhea 6%, syphilis 8%), as was staff use of internet to contact partners (chlamydia 4%, gonorrhea 4%, syphilis 6%). A designated individual was responsible for reporting notifiable diseases in 46% of clinics. HPV vaccine was provided to females by 92% and to males by 71% of clinics. For patients diagnosed with HIV, 90% of clinics confirmed a visit to an HIV care provider.

Conclusions: Most surveyed FQHC clinics in NYC followed STD diagnosis and management recommendations. Improved partner services, case reporting, and vaccine uptake may be attained through electronic reminders, given the widespread use of EHR in FQHC clinics.