From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA.
Sex Transm Dis. 2020 May;47(5):347-353. doi: 10.1097/OLQ.0000000000001145.
High-risk sexual behaviors (HRSB) are associated with sexually transmitted infections (STIs). The Centers for Disease Control and Prevention and US Preventive Services Task Force recommend routine testing for patients with HRSB. Providers can classify patients with HRSB based on the sex of their sex partners using the International Classification of Disease Tenth Revision. We analyzed STI/human immunodeficiency virus (HIV) testing frequencies among patients with HRSB.
This study used a large US administrative outpatient medical claims data set from 2015 to 2017. Patients aged 15 to 64 years were identified with HRSB using International Classification of Disease Tenth Revision codes. An initial HRSB diagnosis in 2016 served as the index date. We assessed chlamydia, gonorrhea, syphilis, and HIV testing by HRSB at the index date, and 4 time intervals of 1 to 6 months, and 7 to 12 months before and after the index date.
We identified 52,160 patients with HRSB: 90.3% were patients with opposite-sex partners, 7.7% patients with same-sex partners, and 2.1% patients with same- and opposite-sex partners. There were 77.5% and 82.1% of the patients insured 6 months before and after the index, respectively. On the index date, patients with opposite-sex partners tested most for chlamydia (65.3%) and gonorrhea (65.2%), patients with same-sex partners tested most for syphilis (51.5%) and HIV (57.8%). Among insured patients, follow-up STI/HIV testing was 89.5% during 1 to 6 months and 33.1% during 7 to 12 months after the index date. Patients tested on the index date were more likely to have an STI/HIV test within 1 to 6 months after the index date.
The STI/HIV testing among patients with HRSB could improve. It is important for patients identified as HRSB to get tested and continue testing patients based on recommendations.
高危性行为（HRSB）与性传播感染（STI）有关。疾病控制与预防中心和美国预防服务工作组建议对 HRSB 患者进行常规检测。提供者可以根据性伴侣的性别使用国际疾病分类第十版对 HRSB 患者进行分类。我们分析了 HRSB 患者的性传播感染/人类免疫缺陷病毒（HIV）检测频率。
本研究使用了 2015 年至 2017 年期间来自美国一个大型行政门诊医疗索赔数据。使用国际疾病分类第十版代码确定 15 至 64 岁的 HRSB 患者。2016 年的初始 HRSB 诊断作为索引日期。我们根据 HRSB 在索引日期以及索引日期前和后 1 至 6 个月和 7 至 12 个月的 4 个时间间隔评估了衣原体、淋病、梅毒和 HIV 检测。
我们确定了 52160 例 HRSB 患者：90.3%为异性性伴侣患者，7.7%为同性性伴侣患者，2.1%为同性和异性性伴侣患者。索引前后分别有 77.5%和 82.1%的患者参保。在索引日期，异性性伴侣患者的衣原体（65.3%）和淋病（65.2%）检测最多，同性性伴侣患者的梅毒（51.5%）和 HIV（57.8%）检测最多。在参保患者中，索引日期后 1 至 6 个月内的后续性传播感染/艾滋病毒检测率为 89.5%，7 至 12 个月内的检测率为 33.1%。在索引日期接受检测的患者更有可能在索引日期后 1 至 6 个月内进行性传播感染/艾滋病毒检测。
HRSB 患者的性传播感染/艾滋病毒检测率有待提高。对于被确定为 HRSB 的患者，根据建议进行检测并继续检测患者非常重要。
