title: Demographic and Health Services Characteristics Associated With Testing for Sexually Transmitted Infections Among a Commercially Insured Population of HIV-Positive Patients.
abstract: BACKGROUND
  Presence of a sexually transmitted infection (STI) can increase the likelihood of HIV transmission, and current treatment guidelines indicate that HIV-positive persons should be screened yearly for STIs. Therefore, we examined recent insurance claims data to determine whether private insurance beneficiaries who are HIV-positive were receiving recommended STI testing.
  
  
  METHODS
  We used data from the 2011 and 2012 MarketScan data sets, a longitudinal population-based database that collects claims from commercially insured persons in private insurance and is conducted by Truven Health Analytics. Over a 13-month period, we calculated rates of testing for chlamydia, gonorrhea, and syphilis among an HIV-positive population and determined the factors that contributed to differences in testing rates.
  
  
  RESULTS
  Overall testing rates were 22.2% for chlamydia, 21.9% for gonorrhea, and 51.1% for syphilis. Significant predictors of STI testing were sex, age, type of health plan, engagement with the health care system, and geographic location. Most notably, persons receiving viral load testing were more likely to receive testing for chlamydia [odds ratio (OR): 1.72; 95% confidence interval (CI): 1.63 to 1.81], gonorrhea (OR: 1.72; 95% CI: 1.64 to 1.81), and syphilis (OR: 3.38; 95% CI: 3.25 to 3.53) compared with persons not receiving viral load testing.
  
  
  CONCLUSIONS
  Not all commercially insured HIV-positive patients are receiving recommended testing for STIs. Presence of STIs could affect the transmission of HIV and has deleterious effects on health outcomes of the patients. Targeted efforts based on demographics, health plan type, and other quality-of-care measures could help identify populations for whom testing rates for STIs among HIV-positive persons could be improved.
authors.affiliation: *Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention, Atlanta, GA; †Department of Family and Preventive Medicine, University of California, San Diego, CA; ‡Graduate School of Public Health, San Diego State University, San Diego, CA; and §Division of HIV and AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: William S
authors.initials: WS
authors.lastname: Pearson
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Davis
authors.forename: Karen W
authors.initials: KW
authors.lastname: Hoover
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Gift
authors.forename: Kwame
authors.initials: K
authors.lastname: Owusu-Edusei
authors.forename: Guoyu
authors.initials: G
authors.lastname: Tao
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007348:Insurance, Health / Q000458:organization & administration* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012749:Sexually Transmitted Diseases / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult