From the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
AcademyHealth, Washington, DC.
South Med J. 2023 Jun;116(6):455-463. doi: 10.14423/SMJ.0000000000001564.
The purpose of this study was to measure sexually transmitted infection (STI) testing among Medicaid enrollees initiating preexposure prophylaxis (PrEP) to prevent human immunodeficiency virus. Secondary data are in the form of Medicaid enrollment and claims data in six states in the US South.
Research partnerships in six states in the US South developed a distributed research network to accomplish study aims. Each state identified all first-time PrEP users in fiscal year 2017-2018 (combined N = 990) and measured the presence of STI testing for chlamydia, syphilis, and gonorrhea through 2019. Each state calculated the percentage of individuals with at least one STI test during 3-, 6-, and 12-month follow-up periods.
The proportion of first-time PrEP users that received an STI test varied by state: 37% to 67% of all of the individuals in each state who initiated PrEP received a test within the first 6 months of PrEP treatment and 50% to 77% received a test within the first 12 months.
Although the Centers for Disease Control and Prevention recommends STI testing at least every 6 months for PrEP users, our analysis of Medicaid data suggests that STI testing occurs less frequently than recommended in populations at elevated risk of syphilis, gonorrhea, and chlamydia.
本研究旨在衡量接受 Medicaid 保险的人群在开始暴露前预防（PrEP）以预防人类免疫缺陷病毒（HIV）时进行性传播感染（STI）检测的情况。次要数据以美国南部六个州的 Medicaid 参保和索赔数据的形式呈现。
美国南部六个州的研究合作方组建了一个分布式研究网络，以实现研究目标。每个州确定了 2017-2018 财年所有首次接受 PrEP 的使用者（合并 N = 990），并通过 2019 年的数据，衡量了衣原体、梅毒和淋病的 STI 检测情况。每个州计算了在 3、6 和 12 个月随访期间至少接受过一次 STI 检测的个体的比例。
接受 STI 检测的首次 PrEP 用户比例因州而异：每个州接受 PrEP 治疗的所有初次使用者中，有 37%至 67%的人在 PrEP 治疗的前 6 个月内接受了检测，有 50%至 77%的人在 PrEP 治疗的前 12 个月内接受了检测。
尽管疾病控制与预防中心（CDC）建议 PrEP 用户至少每 6 个月进行一次 STI 检测，但我们对 Medicaid 数据的分析表明，在感染梅毒、淋病和衣原体风险较高的人群中，STI 检测的频率低于建议的频率。
