TP 102 Offering Comprehensive Risk Assessment and STI Screening to HIV-Infected Persons: Assuring the Standard of Care

Tuesday, June 10, 2014
Exhibit Hall
Jennifer Creighton, BS1, Angela Corbin, BA, MPH1, Tynekua Smith, BA2, Pradnya Tambe, MD1, Michelle Allen, BA3, Matthew McKenna, MD, MPH4, Laura Bachmann, MD, MPH5, Seema Nayak, MD6, Anne Rompalo, MD, ScM7 and Terry Hogan, BA, MPH8, 1Communicable Disease Prevention Branch, Fulton County Department of Health and Wellness, Atlanta, GA, 2School of Medicine, Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, 3STD Office, Georgia Department of Public Health, Atlanta, GA, 4Health & Wellness, Fulton County Department of Health & Wellness, Atlanta, GA, 5Infectious Diseases Section, Wake Forest University Health Sciences, Winston-Salem, NC, 6Department of Medicine, Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, 7School of Medicine, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, 8Bayview Medical Campus, Johns Hopkins Univerisity, Baltimore, MD

Background:  Atlanta is among the 12 U.S. cities with the highest  burden of HIV/AIDS.    In 2012, the HIV/AIDS Primary Clinic (HIVC) at Fulton County Department of Health and Wellness (FCDHW) and the Georgia Department of Public Health (GDPH) participated with the STD/HIV Prevention Training Center (PTC)  in a project focused on the HIV providers at the HIVC to increase:  1) screening for sexual risk behaviors; 2) screening testing for other sexually transmitted infections (STIs) such as syphilis, gonorrhea  (GC) and chlamydia (CT); and, 3) extra-genital screening to rule out asymptomatic STIs in the rectum or throat. 

Methods:  A baseline record review was done for all HIV-infected patients presenting for services at the HIVC in November, 2012.  In December 2012, a brief training was offered to all the providers, two provider champions were identified and a risk assessment tool was introduced.   These interventions were followed by a repeat record review in January 2013.

Results:  During the month of November 2012, a total of 521 patients were seen at the HIVC (386 males and 135 females), of those, 9.3% (36/386) males and 8.9% (12/135) females were tested for CT/GC.  No extra-genital tests were performed.  In the month of January 2013, 557 patients presented for care (433 males, 124 females), 100% were assessed for STI risk, and CT/GC screening increased to 9.5% (41/433) in males and 12.1% (15/124) in females, an increase of 2% and 36% respectively.  Based on the risk assessment, no extra-genital tests were performed.   

Conclusions:  These results indicate that there were gaps in service.  Providers’ increased awareness resulted in identifying patients at-risk for acquiring other STIs and offered an opportunity to counsel patients about risks for acquiring STIs.  These findings indicate that offering provider training and incorporating a risk assessment reminder into the chart can assist the provider in identifying patients needing STI screening.