Abstract:
Rates of chlamydia (CT) and gonorrhea (GC) have risen for the first time in the United States since 2006. Certain population groups are disproportionately affected by these sexually transmitted infections (STIs) as well as HIV. The Centers for Disease Control and Prevention (CDC) and professional societies have published screening guidelines for these STIs for women under the age of 25. We aimed to quantify physician adherence to GC/CT and HIV screening guidelines and to determine demographic factors associated with GC/CT and HIV screening recommendations among women 14-25 years old in Honolulu, Hawai\'i. We conducted a retrospective chart review of all visits to an OB/GYN teaching clinic in 2014 to determine rates of STI screening recommendations and evaluate differences in screening recommendations by demographic factors such as patient age, race, insurance type, visit type, and visit number during the study period. Electronic medical records of 726 visits by 446 patients were reviewed. Among visits by patients with indications for screening, 71.0% and 21.6% received screening recommendations for GC/CT and HIV, respectively. Age group, race, and visit type were significantly associated with receiving screening recommendations. A lack of appropriate documentation regarding the assessment of risk factors for GC/CT and HIV screening was observed. Emphasis should be placed on more thorough ascertainment and documentation of patients\' risk factors for STI acquisition to determine screening needs at each clinical visit based on professional guidelines, as substantial public health benefits may be gained through the identification and prompt treatment of GC/CT and HIV infections.
摘要:
自2006年以来,衣原体(CT)和淋病(GC)的发病率在美国首次上升。某些人群受到这些性传播感染(STIs)和艾滋病毒的影响不成比例。疾病控制和预防中心(CDC)和专业协会已经发布了针对25岁以下女性的这些性传播感染的筛查指南。我们旨在量化医生对GC/CT和HIV筛查指南的依从性,并确定檀香山14-25岁女性中与GC/CT和HIV筛查建议相关的人口统计学因素。夏威夷.我们在2014年对所有访问OB/GYN教学诊所进行了回顾性图表审查,以确定性传播感染筛查建议的比率,并通过人口统计学因素(如患者年龄)评估筛查建议的差异。种族,保险类型,访问类型,以及研究期间的访视次数。对446例患者的726次就诊的电子病历进行了审查。在有筛查指征的患者就诊中,71.0%和21.6%接受了GC/CT和HIV筛查建议,分别。年龄组,种族,访视类型与接受筛查建议显著相关.观察到缺乏有关GC/CT和HIV筛查风险因素评估的适当文件。重点应放在更彻底的确定和记录患者性传播感染的危险因素,以根据专业指南确定每次临床就诊时的筛查需求。因为通过识别和及时治疗GC/CT和HIV感染,可以获得实质性的公共卫生益处。