Factors Associated with STD Infection and Re-Infection Across the Lifespan

Background: Sexually transmitted diseases (STDs) can cause serious reproductive, perinatal, and fetal health concerns across the lifespan, and are often asymptomatic and undetected.  Determining the prevalence and risk factors associated with sexually transmitted infections and re-infections are critical steps in implementing strategies for reduction. The CDC has issued STD Treatment Guidelines (2015), which emphasize the importance of retesting to detect repeat infection.

Methods: A retrospective chart review was conducted on 163 medical records from a family planning clinic. Data was collected using age, race, gender, number of sexual partners, condom use, sites of sexual contact, history of and type of STD, and reasons for clinic visit. Data was analyzed using exploratory descriptive statistics to describe the sample. Means and standard deviations were used for continuous variables. Frequencies and percents were used for categorical variables.

Results: The sample comprised of n=131 females, n=32 males; African Americans comprised almost half of the study population (44%).  The ages ranged from18-60 (mean age 24). The most common STDs diagnosed were Chlamydia (39%) and Trichomonas Vaginalis (TV) (25%).  Thirty seven percent had a prior STD, with 23% of the prior history being Chlamydia. The main purpose for the clinic visit was due to self-reporting of symptoms (42%) and the charting reflected that 28% of patients visited the clinic for routine screening and were asymptomatic. There was a mean reported number of 7 lifetime sexual partners. Seventy percent reported engaging in only vaginal sex and 59% did not use condoms. At least 57% of all providers (NPs or PAs) documented STD and/or HIV prevention counseling at the time of the visit. 

Conclusions:Provider initiated STD counseling was documented during the visit and consistent with CDC guidelines yet subjects reported a low rate of condom use.  STD counseling may not be effective in the increase of condom use in this population.