Screening, Brief Intervention and Referral to Treatment Model to Reduce High Risk Sexual Behavior and Substance Use in New York City Department of Health and Mental Hygiene's Sexually Transmitted Disease Clinics, May 1, 2008- September 30, 2013

Background: Alcohol and other drug (AOD) use has been associated with sexual risk taking and acquisition of sexually transmitted diseases (STDs), including HIV. Identifying substance use disorders (SUDs) and providing timely screening and intervention could reduce AOD use and STDs. The Screening, Brief Intervention and Referral to Treatment (SBIRT) model, an evidence-based approach addressing substance use in clinical settings, has been in use at NYC STD clinics since May 2008. Outcomes are presented below.

Methods: From May 1, 2008 through September 30, 2012, the SBIRT model was used to screen patients for SUD.  Patients answering ‘yes’ to any of the self-administered screening questions were offered a single-session brief intervention using the SBIRT model. The intervention utilizes stages of change theory and motivational interviewing techniques to address patients’ AOD use. When warranted, patients were referred to substance abuse treatment.  Screening results were documented in the electronic medical records. Analyses, using SAS 9.2, measured changes from SUD positive screening during initial visit to a negative screening during subsequent visits (N= 3,684). STD diagnoses at initial and subsequent visits were also examined.

Results: SUD positive screened patients who received a brief intervention were more likely to screen negative for SUD [OR 1.46 (95%CI 1.27-1.67) p <0.001] and less likely to be diagnosed with an STD [OR 0.68 (95%CI 0.54-0.86), p = .0016] in subsequent STD clinic visits as compared to SUD positive screened patients who did not receive an intervention.

Conclusions: Results demonstrate the effectiveness of SBIRT within NYC STD clinics in reducing reported substance use and STD diagnoses in subsequent NYC STD clinic visits.