title: HIV screening in commercially insured patients screened or diagnosed with sexually transmitted diseases or blood-borne pathogens.
abstract: BACKGROUND
  The Centers for Disease Control strongly recommends HIV screening for all patients who present to health care settings with sexually transmitted diseases (STD) or blood-borne pathogens exposure. The objective of this study is to assess the rates and determinants of HIV screening in a national sample of commercially insured patients screened or diagnosed with an STD or hepatitis B or C.
  
  
  METHODS
  We used Poisson regression model with a robust error variance to assess the determinants of HIV screening using administrative claims data from health plans across 6 states (n = 270,423).
  
  
  RESULTS
  The overall HIV screening rate of patients who were diagnosed or screened for STDs or hepatitis was low (32.7%); rates were lowest for patients presenting with epididymitis or granuloma inguinale (<10%). Patients aged 25 to 34 years were more likely to be screened than other age groups. Females were significantly less likely to be screened for HIV (prevalence ratio = 0.90; 95% CI = 0.89, 0.91) than males. Patients living in states where no written HIV informed consent was required were significantly more likely to be screened than those living in states where written HIV informed consent was specifically required.
  
  
  CONCLUSIONS
  HIV screening rates were low and varied by STD categories. Females and younger and older patients were at increased risk of no HIV screening. Requiring specific written informed consent for HIV screening resulted in less HIV screening. Interventions are urgently needed to increase the HIV screening rate among this at-risk population.
authors.affiliation: Payer Solutions, IMS Health, Woodland Hills, CA, USA. judy.chen@us.imshealth.com
authors.forename: Judy Ying
authors.initials: JY
authors.lastname: Chen
authors.forename: Qiufei
authors.initials: Q
authors.lastname: Ma
authors.forename: Francois
authors.initials: F
authors.lastname: Everhard
authors.forename: Irina
authors.initials: I
authors.lastname: Yermilov
authors.forename: Haijun
authors.initials: H
authors.lastname: Tian
authors.forename: Kenneth Hugh
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000293:Adolescent; D000328:Adult; D017848:Blood-Borne Pathogens; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007345:Insurance Claim Review; D007348:Insurance, Health; D038801:International Classification of Diseases; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States; D055815:Young Adult