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Physician Adherence to Sexually Transmitted Infection Screening Guidelines in an OB/GYN Teaching Clinic in Hawai'i
Alyssa Dee P Carlson1, Mary Tschann1, Somsook Santibenchakul1
1Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (ADCP, SS, EH).
Insights
Physician adherence to screening guidelines for chlamydia, gonorrhea, and HIV among young women in Honolulu was low. Improved documentation of risk factors is crucial for effective STI prevention and treatment.
Area of Science:
- Public Health
- Infectious Diseases
- Gynecology
Background:
- Rates of chlamydia (CT) and gonorrhea (GC) are rising in the U.S., with certain groups disproportionately affected by these sexually transmitted infections (STIs) and HIV.
- Screening guidelines for STIs and HIV exist for women aged 14-25, yet adherence varies.
- Understanding adherence and associated factors is vital for improving STI prevention in young women.
Purpose of the Study:
- To quantify physician adherence to CT/GC and HIV screening guidelines in women aged 14-25 in Honolulu, Hawai'i.
- To identify demographic factors associated with CT/GC and HIV screening recommendations.
- To highlight the need for improved risk factor assessment and documentation for STI screening.
Main Methods:
- Retrospective chart review of 726 visits by 446 patients at an OB/GYN teaching clinic in 2014.
- Evaluation of screening recommendations for CT/GC and HIV based on established guidelines.
- Analysis of demographic factors (age, race, insurance, visit type, visit number) associated with screening.
Main Results:
- Only 71.0% of eligible visits resulted in CT/GC screening recommendations, and 21.6% for HIV.
- Patient age, race, and visit type were significantly associated with receiving screening recommendations.
- Inadequate documentation of risk factor assessment for STI screening was noted.
Conclusions:
- Physician adherence to STI and HIV screening guidelines for young women in Honolulu is suboptimal.
- Demographic factors influence screening recommendations, indicating potential disparities.
- Enhanced documentation of risk factors is essential to ensure guideline adherence and improve public health outcomes through early STI detection and treatment.
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.
