Sexually transmitted infection clinics as safety net providers: exploring the role of categorical sexually transmitted infection clinics in an era of health care reform.
Sexually transmitted infection clinics as safety net providers: exploring the role of categorical sexually transmitted infection clinics in an era of health care reform.
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DOI：
10.1097/olq.0000000000000255
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发表时间：
2015-05
影响因子：
3.1
通讯作者：
SSuN Working Group
中科院分区：
文献类型：
--
作者：
Pathela P;Klingler EJ;Guerry SL;Bernstein KT;Kerani RP;Llata L;Mark HD;Tabidze I;Rietmeijer CA;SSuN Working Group
对许多人来说，实施美国平价医疗法案将涉及到性传播感染（STI）护理和预防的公共医疗场所向私人医疗场所的过渡。为了预测初级保健提供者可能面临的挑战，并为公共资助的性传播感染诊所的未来作用提供信息，考虑它们目前的功能是有益的。作为性传播疾病监测网络一部分的40家性传播疾病诊所收集的数据用于描述2010年和2011年患者人口统计学和行为特征、性传播疾病诊断和实验室检测数据。共有363,607名独特患者进行了608,536次门诊就诊。大多数患者为男性（61.9%）；21.9%的男性报告与男性发生性关系（MSM）。大约一半的患者年龄在20至29岁之间（47.1%），非西班牙裔黑人（56.2%）。有212,765例性传播感染诊断（大多未报告）需要临床检查。进行了大量的衣原体、淋病和艾滋病毒检测（150 000 000次）；衣原体感染率为11.5%，淋病感染率为5.8%，HIV感染率为0.9%，不同性别和男男性行为者的感染率差异较大。感染衣原体或淋病的男男性接触者中，衣原体和淋球菌分别在生殖器外部位检出40.1%（1811/4448）和46.2%（3370/7300）。性传播疾病监测网络诊所服务于性传播疾病高发人群。鉴于在不可报告性传播感染和可报告性传播感染的诊断以及生殖器外衣原体和淋病检测方面的经验，性传播感染诊所构成了性传播感染诊断、治疗和预防方面的重要专业网络。
For many individuals, the implementation of the US Affordable Care Act will involve a transition from public to private health care venues for sexually transmitted infection (STI) care and prevention. To anticipate challenges primary care providers may face and to inform the future role of publicly funded STI clinics, it is useful to consider their current functions. Data collected by 40 STI clinics that are a part of the Sexually Transmitted Disease Surveillance Network were used to describe patient demographic and behavioral characteristics, STI diagnoses, and laboratory testing data in 2010 and 2011. A total of 608,536 clinic visits were made by 363,607 unique patients. Most patients (61.9%) were male; 21.9% of men reported sex with men (MSM). Roughly half of patients were 20 to 29 years old (47.1%) and non-Hispanic black (56.2%). There were 212,765 STI diagnoses (mostly nonreportable) that required clinical examinations. A high volume of chlamydia, gonorrhea, and HIV testing was performed (>350,000 tests); the prevalence was 11.5% for chlamydia, 5.8% for gonorrhea, 0.9% for HIV, and varied greatly by sex and MSM status. Among MSM with chlamydia or gonorrhea, 40.1% (1811/4448) of chlamydial and 46.2% (3370/7300) of gonococcal infections were detected at extragenital sites. Sexually Transmitted Disease Surveillance Network clinics served populations with high STI rates. Given experience with diagnoses of both nonreportable and reportable STIs and extragenital chlamydia and gonorrhea testing, STI clinics comprise a critical specialty network in STI diagnosis, treatment, and prevention.