HIV and Syphilis Co-Screening Rates Among Patients Tested for Gonorrhea and Chlamydia at a Large, Urban Hospital

Abstract

Abstract Background Current guidelines recommend concurrent screening for HIV and syphilis with gonorrhea and chlamydia testing. Despite this, many patients are still not screened. This study describes trends in demographics and encounter locations associated with missed opportunities for HIV and syphilis screening among patients tested for gonorrhea or chlamydia. Methods This is a retrospective review of all encounters with gonorrhea or chlamydia testing in a large, urban hospital from November 1, 2018, to July 31, 2021. Demographic information and encounter location were extracted from the medical record. Encounters were categorized as including both HIV and syphilis (complete) screening, HIV screening only, or neither. Logistic regression was used to examine associations between demographics and encounter location and likelihood of complete screening. Results There were 42,791 patient encounters, of which 40.2% had complete screening, 6.2% had concurrent HIV screening only, and 53.6% had no concurrent screening. Increasing age, female sex (aOR 0.58, 95% CI 0.55-0.61, p < 0.01), non-Hispanic Black race (aOR 0.52, 95% CI 0.49-0.55, p < 0.01), and public insurance (aOR 0.72, 95% CI 0.69-0.75, p < 0.01) were associated with lower odds of complete screening. Emergency department (ED) encounters were most likely to include complete screening (aOR 3.11, 95% CI 2.96-3.26, p < 0.01). Conclusions This study found a large proportion of patients tested for gonorrhea and chlamydia had missed opportunities for HIV and syphilis screening. Significant demographic disparities were found. The ED was most likely to screen for both HIV and syphilis. Decreasing disparities in screening could have profound effects on the HIV and syphilis epidemics.