2F 3 Technical Assistance and Training Increases STD Screening in HIV Care Settings

Tuesday, June 10, 2014: 3:20 PM
Mark Thrun, MD, HIV/STD Prevention and Control, Denver Public Health, Denver, CO, Teri Anderson, MT, (ASCP), Denver STD/HIV Prevention Training Center, Denver Public Health Department, Denver, CO, Sharon Devine, JD, PhD, Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO, Aran Nichol, MD, Department of Medicine, Division of Infectious Diseases, Denver Health, Richard Beech, MD, Legacy Community Health, Ank Nijhawan, MD, MPH, Univ of Texas Southwestern Medical Center and Edward Gardner, MD, Infectious Diseases Clinic, Denver Public Health, Denver, CO

Background: Though syphilis screening in HIV care has been readily taken up by providers, screening for gonorrhea and chlamydia has historically lagged in these settings, even in the higher-risk population of men who have sex with other men (MSM). In order to address this disparity, the Denver Prevention Training Center partnered with 4 urban HIV clinics disproportionately serving MSM to provide training and technical assistance related to STD screening in those MSM living with HIV.

Methods: Through professional contacts, the Denver PTC identified a clinician champion at each of 4 HIV clinics (2 in CO, 2 in TX). Each clinic was asked to undertake a structured review of STD screening data for syphilis, gonorrhea, and chlamydia performed in their clinic in the last 12 months. The Denver PTC then worked with the clinician champion to identify and address barriers to increased screening in those settings and offered a 1-hour training session to all clinicians and clinic support staff in the individual clinics. Six months after the training clinics were asked to review STD screening data again. Pre- and post-capacity building services data were compared.

Results:  Across all four clinics the number of patients screened for gonorrhea and chlamydia increased 23.4%. The percentage increase in the number of persons screened at the clinic level ranged from 7.6% to 137%. Collectively, patients screened for syphilis increased 5.9%, with clinics ranging from 2.5% to 11.9%. Two of 3 clinics unable to perform NAAT testing at rectal or pharyngeal sites prior to the project adopted procedures that allowed for screening in these anatomic sites.

Conclusions: When coupled with provider training, clinic-level technical assistance including the identification of a local champion, structured review of local data, review and addressing of barriers, and ongoing communication, can positively impact STD screening rates in HIV clinical settings.