From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
Sex Transm Dis. 2024 Jul 1;51(7):472-479. doi: 10.1097/OLQ.0000000000001966. Epub 2024 Jun 3.
The association between illicit opioid use and prescription opioid misuse and sexually transmitted infections (STIs) has not been examined recently. Our study aimed to explore differences in STI/HIV care, and delivery of recommended testing and diagnoses among patients with and without opioid use disorder (OUD).
Using 2019 MarketScan commercial claims data, we identified 15- to 44-year-old male and female patients, to assess the percentages of STI/HIV diagnoses (using International Classification of Diseases, Tenth Revision, Clinical Modification ) and screening (using Current Procedure Terminology codes) among patients with or without OUD diagnoses codes. We further assessed STI/HIV testing and diagnoses by demographic factors.
We identified 24,724 patients with OUD codes among 7.31 million patients. Both STI/HIV testing and diagnoses were significantly ( P < 0.05) higher among patients with OUD codes versus without: testing percentages were 16.81% versus 12.93% for chlamydia, 22.31% versus 16.62% for gonorrhea, 15.26% versus 7.61% for syphilis, and 18.18% versus 7.60% for HIV; diagnoses were 0.80% versus 0.35% for chlamydia, 0.30% versus 0.11% for gonorrhea, 0.23% versus 0.07% for syphilis, and 0.74% versus 0.33% for HIV. Similarly, among 0.53 million 15- to 24-year-old females who received services suggestive of sexual activity, chlamydia testing was significantly ( P < 0.05) higher among patients with OUD codes versus without (59.78% vs. 55.66%).
Patients with OUD codes have higher percentages of STI/HIV testing and diagnoses codes compared with those without OUD codes. Clinicians may want to consider a comprehensive multidisciplinary (OUD and STI prevention) approach in patient care and provide recommended STI/HIV screening among patients with OUD if not performed.
最近没有研究检查非法阿片类药物使用与处方类阿片类药物滥用和性传播感染（STI）之间的关联。我们的研究旨在探索有和没有阿片类药物使用障碍（OUD）的患者在 STI/HIV 护理以及推荐检测和诊断方面的差异。
使用 2019 年 MarketScan 商业索赔数据，我们确定了 15 至 44 岁的男性和女性患者，以评估有无 OUD 诊断代码的患者中 STI/HIV 诊断（使用国际疾病分类，第十次修订版，临床修正）和筛查（使用当前程序术语代码）的百分比。我们还根据人口统计学因素评估了 STI/HIV 检测和诊断。
我们在 731 万患者中确定了 24724 名有 OUD 代码的患者。有 OUD 代码的患者的 STI/HIV 检测和诊断均显著（P<0.05）高于没有 OUD 代码的患者：衣原体检测百分比分别为 16.81%和 12.93%，淋病为 22.31%和 16.62%，梅毒为 15.26%和 7.61%，艾滋病毒为 18.18%和 7.60%；诊断率分别为 0.80%和 0.35%的衣原体，0.30%和 0.11%的淋病，0.23%和 0.07%的梅毒，0.74%和 0.33%的艾滋病毒。同样，在接受性行为服务的 530 万 15 至 24 岁女性中，有 OUD 代码的患者的衣原体检测率显著（P<0.05）高于没有 OUD 代码的患者（59.78%比 55.66%）。
有 OUD 代码的患者的 STI/HIV 检测和诊断代码百分比高于没有 OUD 代码的患者。如果没有进行，临床医生可能希望在患者护理中考虑采用全面的多学科（OUD 和 STI 预防）方法，并为有 OUD 的患者提供推荐的 STI/HIV 筛查。
