CLINICAL ENCOUNTERS FOR PELVIC INFLAMMATORY DISEASE: MISSED OPPORTUNITIES TO SCREEN FOR SYPHILIS AND HIV?

Abstract

Objectives Rising rates of sexually transmitted and blood borne infections (STBBIs) in Manitoba could be due to missed screening. This study determines the prevalence of concomitant syphilis and HIV screening in women tested for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) when presenting with pelvic inflammatory disease (PID). Methods A retrospective chart analysis was performed of all inpatient admissions for PID, cervicitis or tuboovarian abscess over three years at a single tertiary care center. A total of 124 charts were extracted, 27 of which met inclusion criteria. These were abstracted for clinical and demographic data. Descriptive statistics were performed. Predictive factors influencing concurrent STBBI testing were evaluated using a Chi-square test and logistic regression for significance (p Results Syphilis and HIV screening was performed in 5 patients(18.5%) compared to 24 patients (88.9%) tested for CT/GC when investigating PID. A positive CT or GC result was the strongest predictor of STBBI screening. Sixty percent (3/5) of syphilis/HIV testing was performed reflexively upon report of a positive CT/GC result during the hospital stay. There was no significant correlation with syphilis and HIV screening and presenting complaint, number of tests ordered or risk factors for PID. Age, residence, and length of hospital stay did not influence likelihood of testing. Conclusions Clinical encounters for PID present an important opportunity that is currently being missed to increase screening and diagnosis of rising STBBIs. This study will be expanded to examine rates of STBBI screening and diagnosis following discharge.