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一项利用城市急诊中心提高男男性行为者梅毒筛查服务提供者能力的教育干预措施。

An Educational Intervention to Improve Provider Screening for Syphilis Among Men Who Have Sex with Men Utilizing an Urban Urgent Care Center.

机构信息

Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.

Albert Einstein Medical College, Bronx, NY, USA.

出版信息

J Community Health. 2019 Aug;44(4):822-827. doi: 10.1007/s10900-019-00647-4.

Abstract

Rates of syphilis are increasing in the United States especially among men who have sex with men (MSM). The purpose of this project was to implement an educational intervention based on the 2015 CDC Sexually Transmitted Diseases (STD) Treatment Guidelines for urgent care providers with an emphasis on identifying MSM sexual behavior and appropriate screening for syphilis. An urgent care center was identified as a location where men seek care and where STD testing was occurring. After a baseline provider focus group to identify barriers to STD testing, a patient survey was created and given to clients to increase identification of MSM behaviors and to prompt providers to order syphilis testing. In addition, an educational intervention was implemented to improve provider and staff screening for syphilis. The intervention occurred between September 2015-December 2015. A total of 1341 males were seen with 1067 surveys collected. The mean age was 35.6 and 57.4% were Hispanic. Overall, 72 (5.4%) males identified as MSM. Approximately 50% of all MSM identified had RPRs (n = 37) sent and of these 13.5% (n = 5) tested positive for syphilis. The focus group among urgent care providers and staff identified barriers to syphilis testing. Targeted screening of males using a self-administered questionnaire is acceptable to urgent care populations and may assist in identifying MSM which in turn may help to facilitate syphilis screening and other relevant STI testing pertinent to this population.

摘要

梅毒在美国的发病率正在上升,尤其是在男男性行为者(MSM)中。本项目旨在根据 2015 年疾病预防控制中心(CDC)的性传播疾病(STD)治疗指南,为急诊护理提供者实施一项教育干预措施,重点是识别 MSM 的性行为,并对梅毒进行适当的筛查。确定了急诊中心是男性寻求治疗和进行 STD 检测的地方。在进行基线提供者焦点小组以确定 STD 检测障碍后,创建了患者调查并分发给客户,以增加识别 MSM 行为并促使提供者订购梅毒检测。此外,还实施了一项教育干预措施,以改善提供者和工作人员对梅毒的筛查。干预措施于 2015 年 9 月至 12 月进行。共有 1341 名男性就诊,收集了 1067 份调查。平均年龄为 35.6 岁,57.4%为西班牙裔。总体而言,72 名男性(5.4%)被认定为 MSM。大约 50%的所有 MSM 确定有 RPR(n = 37)发送,其中 13.5%(n = 5)梅毒检测呈阳性。急诊护理提供者和工作人员的焦点小组确定了梅毒检测的障碍。使用自我管理问卷对男性进行有针对性的筛查,可被急诊人群接受,可能有助于识别 MSM,从而有助于促进梅毒筛查和针对该人群的其他相关性传播感染检测。

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