A. Hazra is assistant professor of medicine, Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, Illinois.
K. Stanford is assistant professor of medicine, Section of Emergency Medicine, University of Chicago Medicine, Chicago, Illinois.
Acad Med. 2023 Jun 1;98(6S):S60-S62. doi: 10.1097/ACM.0000000000005182. Epub 2023 Feb 16.
Rates of sexually transmitted infections (STIs) in the United States have continued to increase for nearly a decade as state and local health departments across the country have divested from sexual health services. The resulting closure of municipal STI clinics has led many uninsured and underinsured patients to rely on emergency departments for their sexual health needs. The authors describe the creation of the novel Sexual Wellness Clinic at University of Chicago Medicine in February 2019. The clinic provides comprehensive sexual health care to establish linkage to pre-exposure prophylaxis (PrEP) for HIV, primary care, and other essential services to patients presenting to the emergency department for STI care. Since operationalization, the Sexual Wellness Clinic has served 560 unique patients; 50.5% (n = 283) were cisgender male and 49.5% (n = 277) were cisgender female. The majority of patients were African American (93.4%, n = 523), non-Hispanic or Latinx (96.1%, n = 538), between 18 and 29 years old (62.3%, n = 350), and had Medicaid or were uninsured (84.3%, n = 472). New syphilis diagnoses were identified in 23.5% (132/560) of patients; gonococcal and chlamydial infections were confirmed in 14.6% (82/560) and 13.4% (75/560) of patients, respectively. Same-day PrEP was initiated for 16.1% (90/560) of patients, of which 56.7% were cisgender female. The Sexual Wellness Clinic identified unique candidates for PrEP, notably a large proportion of Black cisgender women; however, further work is needed to support the ongoing PrEP cascade. Identifying these new populations with untreated STIs and other HIV risk factors for targeted, innovative interventions is integral to HIV elimination and STI control efforts.
美国的性传播感染（STI）率在过去十年中持续上升，因为全国各地的州和地方卫生部门都放弃了性健康服务。市政 STI 诊所的关闭导致许多没有保险和保险不足的患者依赖急诊部门满足他们的性健康需求。作者描述了 2019 年 2 月在芝加哥大学医学中心创建新型性健康诊所的情况。该诊所为前来急诊部门就诊的患者提供全面的性健康护理，以建立 HIV 暴露前预防（PrEP）、初级保健和其他基本服务的联系。自运营以来，性健康诊所已经为 560 名独特的患者提供了服务；50.5%（n = 283）为顺性别男性，49.5%（n = 277）为顺性别女性。大多数患者为非裔美国人（93.4%，n = 523）、非西班牙裔或拉丁裔（96.1%，n = 538）、年龄在 18 至 29 岁之间（62.3%，n = 350），并且拥有医疗补助或没有保险（84.3%，n = 472）。新诊断出梅毒的患者占 23.5%（132/560）；淋病和衣原体感染在 14.6%（82/560）和 13.4%（75/560）的患者中得到确认。当天为 16.1%（90/560）的患者启动了 PrEP，其中 56.7%为顺性别女性。性健康诊所确定了 PrEP 的独特候选人群，尤其是很大一部分非裔顺性别女性；然而，需要进一步努力支持持续的 PrEP 级联。识别这些新的性传播感染和其他 HIV 风险因素未得到治疗的人群，为有针对性的创新干预措施提供了机会，这是 HIV 消除和性传播感染控制工作的关键。
