STD Testing Research Articles

The Role of Subjective Norm in Persuasion Through the Restoration of Personal Freedom

ABSTRACT Human behavior is largely influenced by social norms. While the social norm approach is frequently used in public health campaigns, their effectiveness is inconsistent. This study investigated the role of normative reactance – the amplification of subjective norms as a means of restoring threatened freedom – across two health behaviors: college drinking and STD testing. A 2 (message threat: low vs. high) × 2 (health topic: college drinking vs. STD testing) between-subjects experiment was conducted with 765 participants. The results indicated that, similar to attitudes, subjective norms could also be amplified as a self-justification strategy to restore threatened freedom, which led to reduced intention to follow a message recommendation. In addition, results showed that the role of subjective norms and attitudes can vary across health behaviors and individual differences, particularly concerning an individual’s degree of self-monitoring. Theoretical implications, limitations, and future directions are discussed.

Assessing the Unmet Preconception Care Needs of Men in the United States by Race/Ethnicity and Nativity

ObjectiveTo estimate the percentage of men in the U.S. in need of preconception care and to assess gaps in utilization of services by race/ethnicity and nativity, irrespective of intention for children, via cross-sectional analysis of 2017–2019 National Survey for Family Growth (NSFG). Methods: The need for preconception care was defined as non-sterile men who had sexual experience and were with female partner(s) who were not sterile. Thirteen preconception care services were assessed across six domains: family planning, blood pressure, HIV, STD, weight management, and smoking cessation. Multivariable weighted analyses were performed to obtain odds ratios to assess differences in preconception care utilization among participants. Results: Approximately 64% of men were estimated to need preconception care. Substantial disparities in need and service use were found across sociodemographic characteristics. Foreign-born men had significantly higher odds of not receiving three of the thirteen preconception care services, including condom use screening (aOR = 1.67; CI = 1.23–2.26), HIV advice (aOR = 1.76; CI = 1.35–2.29), and STD testing (aOR = 1.66; CI = 1.13–2.44), than U.S.-born. Hispanic men had higher odds of not receiving blood pressure (aOR = 1.39; CI = 1.09–1.79) and smoking screenings (aOR = 1.33; CI = 1.02–1.73) than White men. Black men had the highest use in six of the thirteen preconception care services. Conclusion: Gaps in preconception care utilization suggest a need to further explore potential drivers of disparities, specifically for Hispanic and foreign-born men. Additional research into the timing and quality of care received by men are needed to assess the scope, severity, and prevalence of unmet needs within medically underserved communities.

Utilization of HIV Prevention, Care, and Treatment Services Among Young Men Who Have Sex With Men and Transgender Persons of Color in the U.S. South: A Qualitative Analysis.

To better understand utilization of HIV prevention, care, and treatment services by young men who have sex with men (YMSM) and young transgender persons (YTG), of Black race or Hispanic/Latino/Latina ethnicity in the U.S. South, we conducted semi-structured interviews with 127 clients at one of four community based organizations (CBOs) in Miami, Atlanta, New Orleans/Baton Rouge, or Columbia, South Carolina. Across sites, the service that most commonly drew respondents into the CBO was HIV and STD testing. Other services commonly used included HIV/STI treatment, counseling services/support groups, and PrEP services. Social/organizational/structural facilitators of service utilization include the welcoming climate/culture of the CBOs, ease of access to the services, and transportation services to reach the CBOs. Suggested service enhancements include broader range of comprehensive, navigational-type services beyond HIV testing and service co-location. Research on how to reduce stigma in the surrounding communities may help reduce health disparities experienced by these populations.

Sexually Transmitted Disease-Related Reddit Posts During the COVID-19 Pandemic: Latent Dirichlet Allocation Analysis.

Sexually transmitted diseases (STDs) are common and costly, impacting approximately 1 in 5 people annually. Reddit, the sixth most used internet site in the world, is a user-generated social media discussion platform that may be useful in monitoring discussion about STD symptoms and exposure. This study sought to define and identify patterns and insights into STD-related discussions on Reddit over the course of the COVID-19 pandemic. We extracted posts from Reddit from March 2019 through July 2021. We used a topic modeling method, Latent Dirichlet Allocation, to identify the most common topics discussed in the Reddit posts. We then used word clouds, qualitative topic labeling, and spline regression to characterize the content and distribution of the topics observed. Our extraction resulted in 24,311 total posts. Latent Dirichlet Allocation topic modeling showed that with 8 topics for each time period, we achieved high coherence values (pre-COVID-19=0.41, prevaccination=0.42, and postvaccination=0.44). Although most topic categories remained the same over time, the relative proportion of topics changed and new topics emerged. Spline regression revealed that some key terms had variability in the percentage of posts that coincided with pre-COVID-19 and post-COVID-19 periods, whereas others were uniform across the study periods. Our study's use of Reddit is a novel way to gain insights into STD symptoms experienced, potential exposures, testing decisions, common questions, and behavior patterns (eg, during lockdown periods). For example, reduction in STD screening may result in observed negative health outcomes due to missed cases, which also impacts onward transmission. As Reddit use is anonymous, users may discuss sensitive topics with greater detail and more freely than in clinical encounters. Data from anonymous Reddit posts may be leveraged to enhance the understanding of the distribution of disease and need for targeted outreach or screening programs. This study provides evidence in favor of establishing Reddit as having feasibility and utility to enhance the understanding of sexual behaviors, STD experiences, and needed health engagement with the public.

Predictors of STD Screening From the Indigenist Stress-Coping Model Among Native Adults With Binge Substance Use.

ObjectiveThe American Indian/Alaska Native (AI/AN) population in the U.S. is thriving in spite of settler colonialist efforts of erasure. AI/AN people, however, continue to experience persistent health disparities including a disproportionate burden of substance use and sexually transmitted diseases/infections (STDs/STIs), as well as a disproportionate lack of public health STD screening services and STD prevention interventions grounded in AI/AN social contexts, experiences, and epistemologies. The present study explored how stressors and protective factors based on the Indigenist Stress Coping framework predict STD screening outcomes among Native adults.MethodsWe analyzed baseline self-report data from 254 Native adults ages 18–55 years with recent binge substance use who were enrolled in an evaluation of “EMPWR,” a two-session STD risk reduction program in a rural, reservation-based community in the U.S. Southwest. Logistic regression models with robust variance were used to estimate odds ratios of lifetime STD testing for the theoretical stressors and cultural buffers.ResultsA little over half the sample were males (52.5%, n = 136), with a mean age of 33.6 years (SD = 8.8). The majority (76.7%, n = 195) reported having ever been screened for STD in their life. Discrimination score were significantly associated with lifetime STD testing: The higher discrimination was associated with lower odds of STD testing in the fully adjusted model (aOR = 0.40, 95%CI: 0.18, 0.92). The effects of AI/AN-specific cultural buffer such as participation in traditional practices on STD testing outcomes was in the expected positive direction, even though the association was not statistically significant. Household size was significantly associated with STD screening: The higher the number of people lived together in the house, the higher the odds of STD testing in the fully adjusted model (aOR = 1.19, 95%CI: 1.04, 1.38).ConclusionOur findings suggest that STD prevention programs should take into consideration AI/AN-specific historical traumatic stressors such as lifetime discrimination encounters and how these interact to drive or discourage sexual health services at local clinics. In addition, larger household size may be a protective factor functioning as a form of social support, and the extended family's role should be taken into consideration. Future research should consider improvement in measurements of AI/AN enculturation constructs.

A Quality Improvement Project: Implementation of the Centers for Disease Control and Prevention's Hepatitis C Virus Treatment Guidelines at an Addiction Treatment Center.

This quality improvement project was introduced at an addiction treatment center to implement the Centers for Disease Control and Prevention's (CDC's) hepatitis C virus (HCV) treatment guidelines and offer anticraving medications to patients to improve standards of care of patients with substance use disorders. Patients with opioid use disorders are at the highest risk of contracting HCV. More than 80% of people in the United States with opioid use disorders who use intravenous drugs have contracted HCV. Despite the high prevalence of HCV, patients at treatment centers are being screened only for HCV antibodies (HCV-AB) and are not receiving the CDC's HCV treatment guidelines. The CDC has treatment recommendations of hepatitis panels, full STD testing, and early follow-up care. This quality improvement project utilized the Plan-Do-Study-Act tool. With the application of Plan-Do-Study-Act, for patients identified with HCV-AB, the established CDC HCV treatment guidelines were followed, and the clinical progress of the implementation of the guidelines was monitored. Chart reviews comparing compliance of guidelines before and after the study were implemented. A convenience sample of 125 patients were collected, and of these, 32 patients were found to be HCV-AB+. The findings revealed that 18.75% of patients followed the CDC's HCV recommendations after the quality improvement project compared with 6.25% of patients before the intervention. The number of HIV testing offered increased by 40.00% as a result of the implementation of the project.

Nora Okja Keller’s Fox Girl: Biopolitics, Necropolitics and a State of Exception

This essay aims to discuss the effects of the Korean government’s hygiene policies on the lives of prostitutes and their families in a U. S. military base village, or kijichon in Nora Okja Kelle’s Fox Girl from the viewpoints of Achille Mbembe’s necropolitics and Michel Foucault’s biopolitics. When it comes to prostitution, it can be said that kijichons were in a state of exception, from Georgio Agamben’s perspective. Using sexually transmitted diseases testing (STD testing) as an example, Fox Gil shows how the hygiene policy pushes ex-Japanese comfort woman and kijichon prostitute Duk Hee into a worse life condition, as a prostitute in a show window, “a fish tank,” while also leading her daughter Sookie into prostitution. Because the policy was unconcerned with the test subjects and their families as a biopolitical attempt to ensure the health of the U. S. soldiers, all of the damage goes to them. The biggest problem is that the completely biased policy was implemented, even though state-regulated prostitution in Korea was abolished in 1948, and the Anti-Prostitution Law was enacted in 1961. The terrible result of the government’s policies was that such policies turned kijichons places where women cannot normally live, as we can see when Hyun Jin Kong, another victim of Korean blood- related culture, runs away to America with Sookie’s daughter Myu Myu. (Chosum University)

Overcoming Barriers to Accessing Confidential HIV and STD Testing: Results from a School-Based Health Center

Overcoming Barriers to Accessing Confidential HIV and STD Testing: Results from a School-Based Health Center

Yashica Robinson: championing reproductive health in Alabama

To say that Yashica Robinson has had a few obstacles to overcome in her life is something of an understatement. She is the medical director of the Alabama Women's Center for Reproductive Alternatives in Huntsville, AL, USA, the only provider of abortion care in northern Alabama. “I provide abortion care in a state that vehemently opposes its practice because I strongly believe that women should have a right to self-determination and be able to access abortion care as a component of a comprehensive approach to reproductive health”, she says. Her work means that Robinson is targeted by anti-abortion protesters. Robinson also runs the Alabama Women's Wellness Center, a general obstetrics and gynaecology practice, with her colleagues. “People seem to forget that much of my work does not involve abortion. At the Alabama Women's Wellness Center, I provide routine obstetrical and gynaecological care as well as general primary care services. At the Alabama Women's Center for Reproductive Alternatives, I offer a broad range of services for a majority low-income population, including STD testing and treatment, contraceptive counselling, and preventative health exams, in addition to medical and surgical abortion care”, she says.

1538. Pilot Study of Self-collected Pharyngeal Testing for Chlamydia and Gonorrhea in the Setting of COVID19 Restrictions

BackgroundGiven that many youth and young adults utilize multiple orifices during sexual activity, testing for STIs from multiple anatomical sites can increase rates of diagnosis. However, during the COVID pandemic, obtaining oral swabs by clinical staff was deemed an unacceptable COVID transmission risk and was discontinued in our clinic. To circumvent this obstacle to diagnosis, clinic staff developed a workaround of obtaining patient collected pharyngeal swabs for STI testing. This abstract reviews the results of this pilot intervention.MethodsPatients presenting to an urban youth family planning/STI clinic who desired STI testing and ever engaged in oral sex were offered pharyngeal testing for chlamydia (CT) and gonorrhea (GC). Patients were instructed on how to obtain an oral sample, and subsequently sent outside of the clinic to obtain their individual sample. Chart review was conducted by clinic staff of a two month period during which this protocol was in place, and the following variables were collected: gender, sexual orientation, race/ethnicity, and STD testing results by anatomic site. Simple descriptive statistical analysis were used.Results146 patients received a GC/CT test from > 1 anatomical site, with 34 patients having > 1 positive result. All pharyngeal samples were self-collected. Four patients were positive for GC/CT from throat samples only (12% of positive tests). All were biologically female, including one transgender FTM. Sexual orientation was split evenly between bisexual and heterosexual. Reported race/ethnicity included two African-American, one white, and one “Filipino”. For comparison, of the overall subsample of patients with positive GC/CT results, patients identified as 53% female, 44% male, and 3% FTM; 74% “straight”, 15% bisexual, 9% “gay”, and 3% did not disclose; 29% white, 50% African-American, 21% unknown as other; and 11% Hispanic. Twelve patients were positive for GC/CT from the throat and either rectum and/or urine/vagina/endocervix (35% of positive tests).ConclusionOur experience demonstrates that obstacles created by the COVID crisis can be circumvented with creative strategies. We were able to pick up 12% and 35% of total infections by self-collected pharyngeal swabs in throat only and throat plus other sites, respectively.Disclosures All Authors: No reported disclosures

Abstract PO-055: A systems model of integrating HPV self-sampling and evidence-based intervention strategies for increasing follow-up care for abnormal screening results with existing services at community-based HIV/AIDS service organizations

Abstract Background: Although cervical cancer is preventable, females living with HIV (FLWH) are 3-8 times more at risk compared to females who are HIV negative. Detecting cervical changes at its earliest stages when treatment is most effective is essential to reducing these cancer health disparities among FLWH. Although FLWH are more at risk for developing cervical cancer, many do not adhere to screening guidelines or recommended follow-up care for abnormal results. Therefore, there remains a critical need for increasing community access and reducing structural barriers to cervical cancer screening (including follow-up care for abnormal results) among FLWH. Objective: To describe system integration of existing ASO services and cervical cancer screening evidence-based intervention (EBI) strategies. Methods: We mapped the subsystems of a multi-level systems approach to integrating existing ASO services with cervical cancer EBI strategies to reduce disparities among FLWH. Individual, interpersonal, and organizational variables for our model were obtained from the PI’s (LTW) formative research and a literature review of cervical cancer EBIs. We used the Plectica, a visual mapping software, to build our preliminary model. Our final model will be validated by systems science exerts, healthcare professionals who provide gynecological care to FLWH, and members of the target population (i.e., ASO leaders and employees, FLWH). Results: Our preliminary model denotes the interplay between EBI strategies at the individual, interpersonal and organizational. Successful implementation will increase cervical cancer screening (including follow-up care for abnormal results), which will reduce these cancer health disparities among FLWH. The systems model that we have designed to achieve our program goal is comprised of two balancing loops and one reinforcing loop. Cervical cancer screening represents the stock, whereas adherence and mortality represent the model’s flows. The integration of two ASO subsystems (i.e., STD testing and patient navigation) with EBI strategies provided two strategically located leverage points (STD + HPV self- collected testing) and (patient navigation + follow-up care for abnormal results) for increasing community access to cervical cancer screening for FLWH at the organizational level. Peer navigation was also found to be a strategically located leverage point increasing cervical cancer screening at the interpersonal level. Conclusions: Although EBIs exist, cervical cancer screening via Pap testing alone or Pap/HPV co-testing is suboptimal, as evidence by health disparities among FLWH. An ecological approach is needed to address the complex array of healthcare and other structural barriers that FLWH may encounter when trying to access cervical cancer screening and if need be, follow-up care for abnormal results and treatment. Therefore, a multi-level approach to increasing community access is needed, including the relational dynamics with peer networks at ASOs. Citation Format: Lisa T. Wigfall, Aditi Tomar, Tiffany C. Washington. A systems model of integrating HPV self-sampling and evidence-based intervention strategies for increasing follow-up care for abnormal screening results with existing services at community-based HIV/AIDS service organizations [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-055.

If You Didn’t Document It, It Didn’t Happen: Improving Documentation of Annual Visits at Resident Clinic [14F

INTRODUCTION: Improve documentation of annual exams based on ACOG’s Women’s Preventative Service Initiative. By increasing consistency in documentation, improve provided patient care. METHODS: Study broken into cycles: (1) A needs assessment (2) first intervention (3) post intervention analysis, (4) 2nd intervention, (5) 2nd post intervention analysis. Epic EMR between 10/2018-05/2019 used to review note documentation by examining presence/absence of the following key elements: gynecologic history section, age appropriate screening offered, HPV vaccination status, Flu vaccination status, menstrual flow, inter-menstrual bleed, healthy living tips, sexual partners, sexual dysfunction, STD testing, fertility desire, family history specific to gynecologic cancer, BMI, Smoker status, history of domestic violence, history of mental health issues. Descriptive analysis was performed using Pivot Table function in Microsoft. Chi square and Fisher exact tests were performed to look for statistical significance. RESULTS: One hundred and seven (n=107) notes were evaluated in needs assessment study, documentation scores varied between 1 to 15 out of 18 total. A new note template was introduced to EMR. 68 charts were analyzed and scores varied from 3-18 out of total score of 18. 2nd intervention was implemented with one-on-one feedback to providers. 21 charts were reviewed, scores varied 8-18, out of 18. Overall Median scores improved from 8 to 15 to 18 after each intervention. 15 components were noted to have a statistically significant improvement in documentation. CONCLUSION: Study findings support planned use of the Institute of Healthcare Improvement’s model of Plan-Do-Study-Act (PDSA) cycles to modify the EMR note template. These efforts enhance physician documentation of patient well-being.

The Louisiana Wellness Centers Program for HIV/STD Prevention Among Gay and Bisexual Men and Transgender Persons.

During the conduct of the described demonstration project (2012-2015), the Centers for Disease Control and Prevention funding standard for HIV testing was 1.0% newly diagnosed positivity in non-health care settings. For linkage to HIV medical care, the National HIV/AIDS Strategy goal was 85%, and the funding standard was 80% (the Centers for Disease Control and Prevention and National HIV/AIDS Strategy had no other quantified goals/standards relevant to the project). To determine aggregate quantitative results of HIV/STD testing and engagement in HIV care. Information sources used for this case study analysis included the Louisiana Department of Health funding application, progress and final reports submitted to the Centers for Disease Control and Prevention, and records of communications between these agencies. Six community-based Wellness Centers throughout Louisiana. Gay and bisexual men and transgender persons. New HIV/STD diagnoses from testing, linkage to HIV care, and reengagement in HIV medical care. The percentage of persons who were newly diagnosed with HIV was 1.4% (44/3214). Of the newly diagnosed persons, 91% (40/44) were linked to HIV medical care. Of persons who were identified as out of care, 83% (5/6) were reengaged in HIV medical care. STD testing results showed that 9.0% (294/3251) of the syphilis tests were positive, and 8.3% (803/9719) of the chlamydia/gonorrhea tests were positive. The pharyngeal chlamydia/gonorrhea positivity was 7.6% (256/3375); the rectal chlamydia/gonorrhea positivity was 13% (374/2948); and the urine chlamydia/gonorrhea positivity was 5.1% (173/3396). The demonstration project was successful. The results were used to discontinue funding for a less effective HIV screening program, continue demonstration project activities with other funds, and make policy changes so that extragenital screening for chlamydia/gonorrhea is now the standard at Louisiana clinics that serve gay and bisexual men and transgender persons.

Quantitative evaluation of an innovation contest to enhance a sexual health campaign in China

BackgroundCrowdsourcing method is an excellent tool for developing tailored interventions to improve sexual health. We evaluated the implementation of an innovation contest for sexual health promotion in China.MethodsWe organized an innovation contest over three months in 2014 for Chinese individuals < 30 years old to submit images for a sexual health promotion campaign. We solicited entries via social media and in-person events. The winning entry was adapted into a poster and distributed to STD clinics across Guangdong Province. In this study, we evaluated factors associated with images that received higher scores, described the themes of the top five finalists, and evaluated the acceptability of the winning entry using an online survey tool.ResultsWe received 96 image submissions from 76 participants in 10 Chinese provinces. Most participants were youth (< 25 years, 85%) and non-professionals (without expertise in medicine, public health, or media, 88%). Youth were more likely to submit high-scoring entries. Images from professionals in medicine, public health, or media did not have higher scores compared to images from non-professionals. Participants were twice as likely to have learned about the contest through in-person events compared to social media. We adapted and distributed the winning entry to 300 STD clinics in 22 cities over 2 weeks. A total of 8338 people responded to an acceptability survey of the finalist entry. Among them, 79.8% endorsed or strongly endorsed being more willing to undergo STD testing after seeing the poster.ConclusionsInnovation contests may be useful for soliciting images as a part of comprehensive sexual health campaigns in low- and middle-income countries.

A Study on Distortion of Gisaeng asan Artiste who Transmitted Yeoak Ⅰ :Focusing on the association between Gisaengand STD testing and whether of execution of it

A Study on Distortion of Gisaeng asan Artiste who Transmitted Yeoak Ⅰ :Focusing on the association between Gisaengand STD testing and whether of execution of it

Delayed diagnosis of colorectal sexually transmitted diseases due to their resemblance to inflammatory bowel diseases

ObjectiveSexually transmitted diseases (STDs), mainly lymphogranuloma venereum (LGV), induce colorectal symptoms that may be misdiagnosed as inflammatory bowel disease (IBD). This study describes patients who presented with STDs masquerading as IBD in order to improve understanding of missed diagnosis of colorectal STDs and their association with LGV in Israel. MethodsThis retrospective, descriptive study characterized the clinical, endoscopic, and pathological findings of 16 patients who were diagnosed with a colorectal STD after erroneously being diagnosed with IBD. Molecular genotyping was used to characterize some of the Chlamydia trachomatis isolates. ResultsAll patients were men who have sex with men (MSM), mostly HIV-1-positive, and had clinical and endoscopic findings compatible with IBD. The STD was diagnosed 1–36 months after the initial diagnosis: 14 were positive for Chlamydia trachomatis, of which three were of the LGV2b (ST58) serotype and one was ST 108 serotype. Five were positive for gonorrhea and four were positive for syphilis. Several pathogens were diagnosed in six episodes. ConclusionsColorectal STDs may resemble IBD and therefore their diagnosis may be delayed. IBD symptoms in MSM who engage in non-protected anal sex should prompt at least syphilis and anal PCR for STD testing. If C. trachomatis is diagnosed but LGV subtyping cannot be done, doxycycline 100mg twice daily for 21days should be recommended.

Contagious Kindness Through Pay-it-Forward Gonorrhea and Chlamydia Testing Among Men Who Have Sex with Men in China: A Pragmatic, Quasi-Experimental Study

Background: Chinese MSM rarely receive gonorrhea or chlamydia testing. The purpose of this pilot study was to evaluate a pay-it-forward strategy to increase gonorrhea/chlamydia testing among MSM. Methods: We used a quasi-experimental pragmatic study to compare a pay-it-forward model to standard of care at two free HIV testing sites for MSM. A pay-it-forward gonorrhea/chlamydia dual testing program was implemented for three months, during which men were offered free testing and given the option of donating money toward testing for future participants. Both sites then switched to standard of care for two months, offering dual testing at the standard price of $24 USD. All men completed a survey reporting sociodemographic characteristics, sexual behaviors, and previous STD testing. Findings: 408 men were included in this study. 203 men were offered pay-it-forward, and 205 were offered standard of care. Gonorrhea/chlamydia testing uptake was 53·7% (109/203) in the pay-it-forward group and 5·9% (12/205) in the standard of care group (aOR=19·74, 95%CI 10·03-38·85, p<0·001). This was a first gonorrhea or chlamydia test for 80% (97/121) and 86% (104/121) of total testers, respectively. 4% (5/121) were diagnosed with gonorrhea, and 12% (15/121) were diagnosed with chlamydia. 89% (97/109) of men in the pay-it-forward group donated any amount, and the mean contribution was $10 USD. Donations accrued through pay-it-forward supported 80% of the cost of testing. Interpretation: Pay-it-forward may be a sustainable model for expanding integrated STD/HIV testing services among MSM in China. Funding: National Institutes of Health, Southern Medical University Dermatology Hospital, Doris Duke Charitable Foundation Conflict of Interest: JDT and WT are on the advisory board for SESH Global, which was involved in organizing the study. All other authors declare no competing interests Ethical Approval Statement: Ethical approval for this study was obtained from the institutional review board at the University of North Carolina-Chapel Hill.

How Many Patients Who Present to North Central Bronx Hospital with a Sexually Transmitted Disease (Chlamydia, Gonorrhea) Are Tested for HIV?

Background To determine whether an individual got infected with either Chlamydia trachomatis, N gonorrhea, or both infected, the HIV test was ordered or not.Methods Systematic review and data synthesis of STD and HIV testing results through Quardamed within the 1 month period of November, 2015. Percentage of patients with and without a STD (either Chlamydia trachomatis, N gonorrhea, or both infected) who had HIV test done.Results804 patients were tested for gonorrhea or chlamydia by GC probe during November 2015. Thirty-three of 804 (4.1%) individuals were infected with Chlamydia trachomatis. Of those 20 were tested for HIV by rapid oral test. Six of 804 (0.7%) participants who were infected with N gonorrhea had five HIV rapid test done. Two of 804 (0.3%) participants were infected with both diseases and one patient was tested for HIV. Most patients with a confirmed STD were diagnosed in ED (43.4%) followed by OB/GYN (37.3%). Seventy-two percent of patients who were either infected with chlamydia, gonorrhea or both were tested for HIV. In the ED, 48% had an HIV test vs. 80% in OB/GYN (including family planning).Conclusion The majority of patients were tested for HIV. More patients were tested in OB/GYN compared with the ED likely because an HIV counselor is readily available during clinic hours. Increase in education and training of health care providers and nurses to become more comfortable in testing patients for HIV may increase the number HIV testing when patients present with STDs.Disclosures All authors: No reported disclosures.

Reproductive Healthcare Services and the U.S. Supreme Court: beyond Roe v. Wade and 'Abortion Clinics'

At a time when the United States is sharply divided on women's reproductive rights, the focus has shifted from legality to that of access to reproductive healthcare services. This debate is too often defined by the pro-choice/anti-choice binary. This binary overlooks women who seek reproductive healthcare services for reasons other than abortion (such as pap smears, gynecological check-ups, birth control, STD testing, breast cancer preventive screenings, etc.). Self-proclaimed sidewalk counselors approach these women to convince them that there are alternatives to abortion. While some women may welcome a sidewalk counselor's approach, the women who choose to ignore them more often than not risk being scolded, yelled at, harassed, and humiliated publicly. These interactions leave many of these women shaken, nervous, and deterred from seeking necessary reproductive healthcare services. Many states have enacted buffer zone legislation to protect women trying to access reproductive healthcare clinics, but an overwhelming amount of these laws have been struck down on a First Amendment basis. The Supreme Court has decided these cases without defining who qualifies as a sidewalk counselor and who is properly deemed a more threatening protester against whom a legal action may be brought. This has caused great uncertainty in the law. This paper argues that sidewalk counselors and activists’ protesting against abortion outside of these clinics is futile. Reproductive healthcare clinics offer a wide range of services—not just abortions. Therefore, it is impossible for anti-abortion activists to ascertain who is seeking an abortion and who is not without intruding into women’s personal reproductive choices and medical needs. Buffer zones around reproductive healthcare facilities help protect women’s privacy and their right to access so they may obtain the reproductive healthcare they are entitled to receive.

Raising Awareness of Pre-Exposure Prophylaxis (PrEP) among Women in New York City: Community and Provider Perspectives

This study explored the knowledge, attitudes, and perceived facilitators and barriers to adoption of HIV pre-exposure prophylaxis (PrEP) among black women and Latinas in the Bronx, NY. Data were collected in focus group discussions (FGDs) held separately with staff (n = 21) and black and Latina female clients aged 18 to 50 (n = 23) of four organizations providing health and social services. Participants were also asked to give feedback about four action messages regarding PrEP for a social marketing campaign. Transcripts were analyzed by two researchers using grounded theory. We found that the majority of clients (74%) and staff (57%) had not heard about PrEP before participating in the FGDs. Following brief educational messaging about PrEP, participants identified potential facilitators and barriers to PrEP uptake among women, and expressed enthusiasm for more widespread efforts to raise awareness about PrEP as an HIV prevention option. Participants preferred an action message that was brief, referred to PrEP as a pill, and did not mention condoms or STD testing. These findings demonstrate the need to raise awareness about PrEP among women and build the capacity of women-serving organizations to educate, screen, and refer or provide PrEP services.