Do clinicians screen Medicaid patients for syphilis or HIV when they diagnose other sexually transmitted diseases?

Abstract

Patients diagnosed with gonorrhea or chlamydia are at high risk for HIV and syphilis, and should be offered screening for both. This study measures HIV and syphilis screening rates among Medicaid patients diagnosed with another sexually transmitted disease (STD). Using 1998 Medicaid claims data from 4 states, we identified individuals diagnosed with gonorrhea, urogenital chlamydia, or pelvic inflammatory disease, and then measured the proportion receiving screening tests for HIV and syphilis. Only 25% of STD-diagnosed Medicaid patients received screening tests for syphilis and only 15% for HIV. We found significant state-to-state variability in screening rates. Medicaid patients diagnosed with a nonbloodborne STD represent a high-risk group that is not adequately screened for syphilis and HIV despite repeated contact with medical professionals. Interventions should focus on eliminating missed opportunities for screening these high-risk individuals.