title: STI diagnosis and HIV testing among OEF/OIF/OND veterans.
abstract: OBJECTIVE
  Patients with sexually transmitted infection (STI) diagnosis should be tested for human immunodeficiency virus (HIV), regardless of previous HIV test results.
  
  
  OBJECTIVE
  Estimate HIV testing rates among recent service Veterans with an STI diagnosis and variation in testing rates by patient characteristics.
  
  
  METHODS
  The sample comprised 243,843 Veterans who initiated Veterans Health Administration (VHA) services within 1 year after military separation. Participants were followed for 2 years to determine STI diagnoses and HIV testing rates. We used relative risks regression to examine variation in testing rates.
  
  
  METHODS
  We used VHA administrative data to identify STI diagnoses and HIV testing and results.
  
  
  RESULTS
  Veterans with an STI diagnosis (n = 1815) had higher HIV testing rates than those without (34.9% vs. 7.3%, P<0.0001), but were not more likely to have a positive test result (1.1% vs. 1.4%, P = 0.53). Among Veterans with an STI diagnosis, testing increased from 25% to 45% over the observation period; older age was associated with a lower rate of testing, whereas race and ethnicity, multiple deployments, posttraumatic stress disorder, and substance abuse disorders were associated with a higher rate.
  
  
  CONCLUSIONS
  Since VHA implemented routine HIV testing, overall rates of testing have increased. However, among Veterans at significant risk for HIV because of an STI diagnosis, only 45% had an HIV test in the most recent year of observation. Other patient characteristics such as alcohol and drug abuse were associated with being tested for HIV. Providers should be reminded that an STI is a sufficient reason to test for HIV.
authors.affiliation: *VA Connecticut Healthcare System †Department of Psychiatry, Yale School of Medicine, New Haven, CT ‡Office of Public Health, Department of Veterans Affairs, Washington, DC Departments of §Internal Medicine and Pediatrics ∥Emergency Medicine, Yale School of Medicine ¶Yale School of Nursing, New Haven, CT.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Goulet
authors.forename: Richard A
authors.initials: RA
authors.lastname: Martinello
authors.forename: Harini
authors.initials: H
authors.lastname: Bathulapalli
authors.forename: Diana
authors.initials: D
authors.lastname: Higgins
authors.forename: Mary A
authors.initials: MA
authors.lastname: Driscoll
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Brandt
authors.forename: Julie A
authors.initials: JA
authors.lastname: Womack
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D000367:Age Factors; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D014728:Veterans; D055815:Young Adult