title: Do clinicians screen Medicaid patients for syphilis or HIV when they diagnose other sexually transmitted diseases?
abstract: BACKGROUND
  Patients diagnosed with gonorrhea or chlamydia are at high risk for HIV and syphilis, and should be offered screening for both.
  
  
  OBJECTIVE
  This study measures HIV and syphilis screening rates among Medicaid patients diagnosed with another sexually transmitted disease (STD).
  
  
  METHODS
  Using 1998 Medicaid claims data from 4 states, we identified individuals diagnosed with gonorrhea, urogenital chlamydia, or pelvic inflammatory disease, and then measured the proportion receiving screening tests for HIV and syphilis.
  
  
  RESULTS
  Only 25% of STD-diagnosed Medicaid patients received screening tests for syphilis and only 15% for HIV. We found significant state-to-state variability in screening rates.
  
  
  CONCLUSIONS
  Medicaid patients diagnosed with a nonbloodborne STD represent a high-risk group that is not adequately screened for syphilis and HIV despite repeated contact with medical professionals. Interventions should focus on eliminating missed opportunities for screening these high-risk individuals.
authors.affiliation: National Center for Primary Care at Morehouse School of Medicine, Atlanta, Georgia 30310, USA. RustG@msm.edu
authors.forename: George
authors.initials: G
authors.lastname: Rust
authors.forename: Patrick
authors.initials: P
authors.lastname: Minor
authors.forename: Neil
authors.initials: N
authors.lastname: Jordan
authors.forename: Robert
authors.initials: R
authors.lastname: Mayberry
authors.forename: David
authors.initials: D
authors.lastname: Satcher
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005845:Georgia / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D006297:Health Services Accessibility; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D007345:Insurance Claim Review; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008484:Medicaid; D009515:New Jersey / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology