Do clinicians screen Medicaid patients for syphilis or HIV when they diagnose other sexually transmitted diseases?
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.
Rust
George
G
National Center for Primary Care at Morehouse School of Medicine, Atlanta, Georgia 30310, USA. RustG@msm.edu
Minor
Patrick
P
Jordan
Neil
N
Mayberry
Robert
R
Satcher
David
D
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