Sexually transmitted disease screening and reporting practices in a military medical center

Sexually transmitted diseases (STDs) and their sequelae are responsible for significant human and economic costs. Military personnel are one of many core populations at increased risk for acquiring STDs. This study was designed to assess primary care physician/practitioner compliance with secondary screening recommendations and reporting practices of STDs in a military setting. Data from approximately 27,000 covered lives from the Naval Hospital and the Naval Air Station Branch Medical Clinic in Jacksonville, Florida, were used in this analysis. Because chlamydia is the most prevalent STD, laboratory results indicative of infection with chlamydia from July 1 to December 31, 1996, were used as a marker of a patient population requiring additional (secondary) STD screening. Patients with laboratory-confirmed chlamydia infection were identified using the Composite Health Care System. The medical records of these index cases were then analyzed for the presence of laboratory test results of human immunodeficiency virus (HIV), rapid plasma reagin, and hepatitis B virus (HBV) within 6 months of a positive chlamydia test. To assess compliance with mandated reporting of particular STDs, total laboratory-confirmed cases of chlamydia, syphilis, and HBV were compared with total cases reported to the Office of Preventive Medicine at the Bureau of Medicine and Surgery, U.S. Navy, during a 1-year period from July 1, 1996, to June 30, 1997. In 32% of chlamydia cases, no additional laboratory tests for HIV, syphilis, or HBV were obtained within 6 months. Fourteen percent of chlamydia cases were reported to the Office of preventive Medicine. Compliance with screening for multiple STDs after the identification of a single STD should be improved. In addition, better methods for reporting cases of STDs should be implemented.