title: Factors associated with a clinician's offer of screening HIV-positive patients for sexually transmitted infections, including syphilis.
abstract: This retrospective study assessed whether Quality Improvement Scotland national standards for the sexual health care offered to HIV-positive individuals are being met by the Edinburgh genitourinary (GU) medicine clinic; specifically whether HIV-positive patients are offered: (a) sexually transmitted infection (STI) screening annually and (b) syphilis testing six-monthly. The study also reviewed what factors were associated with a clinician's offer of STI screening and syphilis testing. Of the 509 patients seen within the study period, case notes documented that 64% were offered STI screens, and 69% were offered syphilis testing, results consistent with audits of services elsewhere. Sexual orientation (P < 0.0005), relationship status (P = 0.007) and receipt of antiretrovirals (P = 0.001) were independent predictors of clinician offer of STI screening, while gender (P < 0.0005) and receipt of antiretrovirals (P = 0.063) were independent predictors of offer of syphilis testing. Our results suggest that one explanation for clinicians failing to offer STI screens and syphilis serology testing is their (implicit) risk assessment that STI testing is not required in individual patients.
authors.affiliation: University of Edinburgh Medical School, Edinburgh, UK.
authors.forename: R
authors.initials: R
authors.lastname: Heller
authors.forename: I
authors.initials: I
authors.lastname: Fernando
authors.forename: M
authors.initials: M
authors.lastname: MacDougall
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D010342:Patient Acceptance of Health Care; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000821:virology; D013587:Syphilis / Q000175:diagnosis* / Q000821:virology