Provider Barriers Prevent Recommended Sexually Transmitted Disease Screening of HIV-Infected Men Who Have Sex With Men
Provider Barriers Prevent Recommended Sexually Transmitted Disease Screening of HIV-Infected Men Who Have Sex With Men
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DOI：
10.1097/olq.0000000000000067
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发表时间：
2014-02-01
影响因子：
3.1
通讯作者：
Hoover, Karen W.
中科院分区：
文献类型：
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作者：
Carter, Jarvis W., Jr.;Hart-Cooper, Geoffrey D.;Hoover, Karen W.
背景与男性发生性关系的HIV感染者（MSM）传播和获得性传播疾病（STD）的风险增加。指南建议至少每年在暴露的解剖部位对感染艾滋病毒的男男性行为者进行梅毒、衣原体和淋病筛查，以保护他们及其性伴侣的健康。尽管有这些指导方针，性病筛查一直是次优的，非常低的非生殖器衣原体和淋病检测率。我们的目标是更好地了解艾滋病毒的护理人员在坚持性病筛查艾滋病毒感染的男同性恋者的指南所遇到的障碍。方法我们进行了40个单独的半结构化的采访与医疗保健提供者（医生，中级供应商，护士和健康教育工作者）的艾滋病毒感染的男同性恋者在8个大型艾滋病毒诊所在美国6个城市。提供者被问及他们的性病筛查实践和障碍进行性风险评估的病人。新兴的主题定性dataanalysis.Results确定，虽然大多数卫生保健提供者报告常规梅毒筛查，衣原体和淋病暴露的解剖部位的筛查不太频繁。阻止常规衣原体和淋病筛查的障碍包括时间限制，难以获得性史，语言和文化障碍，以及患者的保密性concerns.Conclusions供应商报告了许多常规衣原体和淋病筛查的障碍。需要采取干预措施，以帮助减少性病筛查的障碍，例如结构性和以患者为导向的卫生服务模式，这可能有助于增加这些重要预防服务的检测覆盖面。
Background HIV-infected men who have sex with men (MSM) are at increased risk for transmitting and acquiring sexually transmitted diseases (STDs). Guidelines recommend at least annual screening of HIV-infected MSM for syphilis and for chlamydia and gonorrhea at exposed anatomical sites, to protect their health and their sexual partners' health. Despite these guidelines, STD screening has been suboptimal, with very low nongenital chlamydia and gonorrhea testing rates. Our objective was to better understand barriers encountered by HIV care providers in adhering to STD screening guidelines for HIV-infected MSM.Methods We conducted 40 individual semistructured interviews with health care providers (physicians, midlevel providers, nurses, and health educators) of HIV-infected MSM at 8 large HIV clinics in 6 US cities. Providers were asked about their STD screening practices and barriers to conducting sexual risk assessments of their patients. Emerging themes were identified by qualitative data analysis.Results Although most health care providers reported routine syphilis screening, screening for chlamydia and gonorrhea at exposed anatomical sites was less frequent. Obstacles that prevented routine chlamydia and gonorrhea screening included time constraints, difficulty obtaining a sexual history, language and cultural barriers, and patient confidentiality concerns.Conclusions Providers reported many obstacles to routine chlamydia and gonorrhea screening. Interventions are needed to help to mitigate barriers to STD screening, such as structural and patient-directed health services models that might facilitate increased testing coverage of these important preventive services.