Medical and Dental, Care South, Baton Rouge, Louisiana, USA.
AIDS Patient Care STDS. 2022 Nov;36(S2):111-116. doi: 10.1089/apc.2022.0110.
In the United States, sexually transmitted infections (STIs) have remained elevated for the fifth consecutive year from 2015 to 2019. There is a need to implement standardization of the US Centers for Disease Control and Prevention STI screening and testing recommendations. Higher STI incidence populations such as people with HIV, men who have sex with men, and adolescents and young adults, are frequently not screened and tested for bacterial STIs as recommended. Federally qualified health centers (FQHCs) have the potential to deliver STI services for at-risk individuals as a routine component of primary care. Comprehensive sexual histories using audio computer-assisted self-interview software on electronic devices were done at each clinic visit at a FQHC. Extragenital site testing for chlamydia and gonorrhea, and blood drawn for syphilis testing was completed onsite based on the sexual history responses. Out of 432 eligible clients, 230 clients consented to having their data used for evaluation in this study. Sexual orientation was reported as heterosexual or straight by 86.5% ( = 199), 10.9% ( = 25) as gay/lesbian/same-sex loving, and 2.6% ( = 6) as bisexual or pansexual. Specimen collection took place over a 16-month period and included 80% ( = 855) urine, 13% ( = 140) pharyngeal, and 6.4% ( = 68) rectal samples. Positivity rates included 10% ( = 7) rectal, 6% ( = 8) pharyngeal, and 2% ( = 20) urine samples. Findings identified higher positivity rates among pharyngeal and rectal specimens compared to urogenital specimens. The feasibility of implementing a comprehensive STI screening and testing process in a FQHC is attainable and beneficial.
在美国,性传播感染(STIs)从 2015 年到 2019 年连续第五年居高不下。有必要实施美国疾病控制与预防中心 STI 筛查和检测建议的标准化。艾滋病毒感染者、男男性行为者以及青少年和年轻人等性传播感染发病率较高的人群,经常未按建议对细菌性 STI 进行筛查和检测。合格的联邦健康中心(FQHC)有潜力将性传播感染服务作为初级保健的常规组成部分提供给高危人群。在 FQHC 的每次就诊时,使用电子设备上的音频计算机辅助自我访谈软件进行全面的性史记录。根据性史的回答,在现场进行外生殖器部位的衣原体和淋病检测,并抽取血液进行梅毒检测。在 432 名符合条件的客户中,有 230 名客户同意将其数据用于本研究的评估。性取向报告为异性恋或直人者占 86.5%(=199),同性恋/女同性恋/同性恋爱者占 10.9%(=25),双性恋或泛性恋者占 2.6%(=6)。标本采集历时 16 个月,包括 80%(=855)的尿液、13%(=140)的咽拭子和 6.4%(=68)的直肠拭子。阳性率包括直肠拭子 10%(=7)、咽拭子 6%(=8)和尿液 2%(=20)。研究结果发现,咽拭子和直肠拭子的阳性率高于尿样。在 FQHC 中实施全面的 STI 筛查和检测流程是可行且有益的。