Improvement of Sexually Transmitted Disease Screening Among HIV-Infected Men Who Have Sex With Men Through Implementation of a Standardized Sexual Risk Assessment Tool.
Improvement of Sexually Transmitted Disease Screening Among HIV-Infected Men Who Have Sex With Men Through Implementation of a Standardized Sexual Risk Assessment Tool.
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通过实施标准化性风险评估工具，改进对男男性行为艾滋病毒感染者的性传播疾病筛查。
DOI：
10.1097/olq.0000000000000333
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发表时间：
2015
影响因子：
3.1
通讯作者：
Park,InaU
中科院分区：
文献类型：
--
作者：
Scarborough,AshleyP;Slome,Sally;Hurley,LeoB;Park,InaU
背景建议至少每年对HIV阳性（HIV+）男男性行为者（MSM）进行淋病（GC）、衣原体（CT）和梅毒筛查。然而，在筛查覆盖率方面存在重大差距。我们进行了一个质量改进干预，以确定是否告知提供商的干预前筛查率和性风险评估将提高性传播疾病（STD）的筛查在一个大型的HIV护理clinic.MethodsIn与凯撒永久北方加州的合作伙伴关系，我们开发和实施了10项评估解决艾滋病毒+男男性接触者之间的性和其他行为风险因素。我们分析了在干预前（2012年6月25日至9月26日）和干预期间（2013年6月25日至9月26日）筛查GC/CT和梅毒的患者比例。观察到GC/CT筛查和梅毒筛查的改善;与干预前相比，接受GC/CT筛查的HIV+ MSM比例在任何解剖部位增加了26.8%（31.6%-40.1%，P= 0.01），在咽部增加了45%（19.5%-28.3%，P= 0.003）。梅毒筛查显着增加了18.8%（48.7%-58.0%，P= 0.009）。ConclusionsOverall STD筛查增加后，观察到这种干预，包括教学培训的紧迫性，艾滋病+男男性接触者，介绍干预前的临床STD筛查数据，自我报告的性风险评估的实施。需要作出更多的努力，以确定可行的方法，准确评估性病筛查的适当性和干预措施的成功，以改善性病筛查。
BackgroundScreening for gonorrhea (GC) and chlamydia (CT) and syphilis among HIV-positive (HIV+) men who have sex with men (MSM) is recommended at least annually. However, significant gaps in screening coverage exist. We conducted a quality improvement intervention to determine whether informing providers of preintervention screening rates and routinizing sexual risk assessment would improve sexually transmitted disease (STD) screening in a large HIV care clinic.MethodsIn partnership with Kaiser Permanente Northern California, we developed and implemented a 10-item assessment addressing sexual and other behavioral risk factors among HIV+ MSM. We analyzed the proportion of patients screened for GC/CT and syphilis in a preintervention period (June 25–September 26, 2012) and during the intervention period (June 25–September 26, 2013).ResultsOf 364 HIV+ MSM seen for care during the intervention period, 47.3% completed the sexual risk assessment. Improvements in GC/CT screening and syphilis screening were observed; when comparing the preintervention period with the intervention period, the proportion of HIV+ MSM receiving GC/CT screening increased by 26.8%(31.6%–40.1%, P= 0.01) at any anatomical site and by 45%(19.5%–28.3%, P= 0.003) at the pharyngeal site. Syphilis screening significantly increased by 18.8%(48.7%–58.0%, P= 0.009).ConclusionsOverall STD screening increases were observed after this intervention that included didactic training on the urgency of STD screening needs for HIV+ MSM, a presentation of preintervention clinic STD screening data, and the implementation of self-reported sexual risk assessment. Additional efforts are needed to determine feasible ways to accurately assess the appropriateness of STD screening and success of interventions to improve STD screening.