Description
There is biological and scientific evidence demonstrating that the likelihood of both transmitting and acquiring human immunodeficiency virus (HIV) increases substantially in the presence of other sexually transmitted diseases (STDs). The testing for and treating of STDs has proven to be an effective tool in both preventing the spread of HIV and reducing the HIV viral load in HIV-infected persons. The Centers for Disease Control and Prevention (CDC) has developed national screening and diagnostic testing guidelines for providers who care for HIV-infected persons. These guidelines recommend asymptomatic routine screening of the curable (bacterial) STDs (e.g., chlamydia, gonorrhea, and syphilis) are performed at least annually for all sexually active, HIVInfected persons. The purpose of this cross-sectional study was to estimate the percentage of STD screening among privately insured patients diagnosed with HIV and determine whether providers who care for HIV-infected persons followed the national screening guidelines set forth by the CDC. Outpatient claims from the 2009 MarketScan database consisting of International Statistical Classifications of Diseases (ICD-9) codes and Current Procedural Terminology (CPT) codes were used to determine HIV diagnoses and STD screening. Variables such as age, sex, health plan type, region, geographic location, claim type, deductible, copayment, and mental health/substance abuse coverage were also included in the analysis. The screening rates of chlamydia, gonorrhea, and syphilis were 19.5%, 19.2%, and 41.8% respectively. The screening rate for patients who were screened for chlamydia, gonorrhea, and syphilis (per the recommendation) was only 14.4%. For the patients who were screened for chlamydia, gonorrhea, and syphilis only sex was significantly associated with screening while geographic location was marginally significantly associated with screening. The results of this study conclude that most HIV-infected persons with private insurance who visited a healthcare professional in 2009 were not screened for chlamydia, gonorrhea, and syphilis. Low screening rates indicate that there are substantial barriers for compliance with the CDC national guidelines and that a range of quality interventions are necessary to improve screening and prevent the spread of STDs within the HIV-infected population.
