Comprehensive Sexually Transmitted Infection Screening and Testing Interventions in a Predominantly Heterosexual Population with HIV at a Health Center

Abstract

In the United States, sexually transmitted infections (STIs) have remained elevated for the fifth consecutive year from 2015 to 2019. There is a need to implement standardization of the US Centers for Disease Control and Prevention STI screening and testing recommendations. Higher STI incidence populations such as people with HIV, men who have sex with men, and adolescents and young adults, are frequently not screened and tested for bacterial STIs as recommended. Federally qualified health centers (FQHCs) have the potential to deliver STI services for at-risk individuals as a routine component of primary care. Comprehensive sexual histories using audio computer-assisted self-interview software on electronic devices were done at each clinic visit at a FQHC. Extragenital site testing for chlamydia and gonorrhea, and blood drawn for syphilis testing was completed onsite based on the sexual history responses. Out of 432 eligible clients, 230 clients consented to having their data used for evaluation in this study. Sexual orientation was reported as heterosexual or straight by 86.5% (n = 199), 10.9% (n = 25) as gay/lesbian/same-sex loving, and 2.6% (n = 6) as bisexual or pansexual. Specimen collection took place over a 16-month period and included 80% (n = 855) urine, 13% (n = 140) pharyngeal, and 6.4% (n = 68) rectal samples. Positivity rates included 10% (n = 7) rectal, 6% (n = 8) pharyngeal, and 2% (n = 20) urine samples. Findings identified higher positivity rates among pharyngeal and rectal specimens compared to urogenital specimens. The feasibility of implementing a comprehensive STI screening and testing process in a FQHC is attainable and beneficial.