Sexually Transmitted Infection Incidence, Screening, & HIV Pre-Exposure Prophylaxis Uptake in United States Veterans with Opioid Use Disorder in Long Island, New York

Abstract

Abstract Background Opioid use disorder (OUD) confers increased risk of contracting bloodborne and sexually transmitted infections (STI). Limited data exists on infectious disease screening and pre-exposure prophylaxis (PrEP) usage among United States Veterans (USV) with OUD, including persons who inject drugs (PWID). This study aimed to evaluate the epidemiology of HIV, hepatitis C virus (HCV), bacterial STI, and PrEP uptake in USV with OUD, including PWID. Methods A retrospective chart review of USV with OUD seeking care at Northport VA Medical Center between 2012-2022 was completed. Sociodemographics, HIV, HCV, STI testing rates and diagnosis, and PrEP uptake were compared between USV, stratified by injection drug use history. Results We identified 502 USV with OUD and 43% had a history of injection drug use. Overall, 2.2% of USV had HIV and 28.7% had HCV. An STI was diagnosed in 10% of USV, most frequently syphilis (1.8%). PWID were more likely to be tested for HIV (93.5% PWID vs. 73.1% non-PWID; p<0.001), HCV (95.8% PWID vs. 80.8% non-PWID; p<0.001) and syphilis (80% PWID vs. 69.2% non-PWID; p=0.006). Total gonorrhea and chlamydia testing rates were 31.9% and 33.7%, respectively, without difference between the groups. PrEP was prescribed in 1.2% of USV. Conclusions In USV with OUD, gonorrhea and chlamydia screening occurred less frequently than syphilis, HCV, and HIV. PWID were more likely to be screened for HIV, HCV, and syphilis. PrEP uptake was low. Both PWID and non-PWID may benefit from increased STI screening and linkage to PrEP.