Advertisement

An Educational Intervention to Improve Provider Screening for Syphilis Among Men Who Have Sex with Men Utilizing an Urban Urgent Care Center

  • Dina Romo
  • Gowri Nagendra
  • Sarah Schechter
  • April Pavlish
  • Alwyn Cohall
  • Natalie NeuEmail author
Original Paper
  • 7 Downloads

Abstract

Rates of syphilis are increasing in the United States especially among men who have sex with men (MSM). The purpose of this project was to implement an educational intervention based on the 2015 CDC Sexually Transmitted Diseases (STD) Treatment Guidelines for urgent care providers with an emphasis on identifying MSM sexual behavior and appropriate screening for syphilis. An urgent care center was identified as a location where men seek care and where STD testing was occurring. After a baseline provider focus group to identify barriers to STD testing, a patient survey was created and given to clients to increase identification of MSM behaviors and to prompt providers to order syphilis testing. In addition, an educational intervention was implemented to improve provider and staff screening for syphilis. The intervention occurred between September 2015–December 2015. A total of 1341 males were seen with 1067 surveys collected. The mean age was 35.6 and 57.4% were Hispanic. Overall, 72 (5.4%) males identified as MSM. Approximately 50% of all MSM identified had RPRs (n = 37) sent and of these 13.5% (n = 5) tested positive for syphilis. The focus group among urgent care providers and staff identified barriers to syphilis testing. Targeted screening of males using a self-administered questionnaire is acceptable to urgent care populations and may assist in identifying MSM which in turn may help to facilitate syphilis screening and other relevant STI testing pertinent to this population.

Keywords

Syphilis Screening test Urgent care setting MSM (men-who-have-sex-with-men) 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors do not have any conflicts of interest to declare.

Supplementary material

10900_2019_647_MOESM1_ESM.pdf (1.4 mb)
Supplementary material 1 (PDF 1422 KB)

References

  1. 1.
    Centers for Disease Control and Prevention. Sexually transmitted disease. STDs in racial and ethnic minorities. Retrieved September 10, 2016 from http://www.cdc.gov/std/stats14/minorities.htm.
  2. 2.
    CDCSTD Surveillance 2017 (figure 39). Retrieved June 11, 2018 from https://www.cdc.gov/std/stats17/figures/39.htm.
  3. 3.
    Schillinger, J., Slutsker, J., Pathela, P., Klingler, E., Hennessy, R., Toro, B., & Blank, S. (2018). The epidemilogy of syphilis in New York CIty: Historic trends and the current outbreak among men who have sex with men, 2016. Sexually Transmitted Diseases, 45, 9S; S48–S54.CrossRefGoogle Scholar
  4. 4.
    Moradi, A., Salek, S., Daniel, E., Gangaputra, S., Osteheimer, T., Burkholder, B., et al. (2015). Clinical features and incidence rates of ocular complications in patients with ocular syphilis. American Journal of Ophthalmology, 159, 334–343.CrossRefPubMedGoogle Scholar
  5. 5.
    Ozturk-Engin, D., Erdem, H., Hasbun, R., Wang, S., Tireli, H., Tattevin, P., et al. (2018). Predictors of unfavorable outcome in neurosyphilis: Multicenter ID-IRI Study. European Journal of Clinical Microbiology & Infectious Diseases.Google Scholar
  6. 6.
    Workowski, K., & Bolan, G. (2015) Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(RR-03), 1–137.Google Scholar
  7. 7.
    Hogben, M., & Leichliter, J. S. (2008). Social determinants and sexually transmitted disease disparities. Sexually Transmitted Diseases, 35(12 Suppl), S13–S18.CrossRefPubMedGoogle Scholar
  8. 8.
    Scott, D. R., Batal, H. A., Majeres, S., Adams, J. C., Dale, R., & Mehler, P. S. (2009). Access and care issues in urban urgent care clinic patients. BMC Health Services Research, 9, 222.CrossRefPubMedGoogle Scholar
  9. 9.
    Schechter, S. B., Romo, D. L., Cohall, A. T., & Neu, N. M. (2017). Approach to human immunodeficiency virus/sexually transmitted infection testing for men at an urban urgent care center. Sexually Transmitted Diseases., 44(4), 255–259.CrossRefPubMedGoogle Scholar
  10. 10.
    Ahmad, F. A., Jeffe, D. B., Plax, K., et al. (2014). Computerized self-interviews improve Chlamydia and gonorrhea testing among youth in the emergency department. Annals of Emergency Medicine, 64(4), 376–384.CrossRefPubMedGoogle Scholar
  11. 11.
    Ghanem, K. G., Hutton, H. E., Zenilman, J. M., Zimba, R., & Erbelding, E. J. (2005). Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients. Sexually Transmitted Infections, 81(5), 421–425.CrossRefPubMedGoogle Scholar
  12. 12.
    Carter, J. W. Jr., Hart-Cooper, G. D., Butler, M. O., Workowski, K. A., & Hoover, K. W. (2014). Provider barriers prevent recommended sexually transmitted disease screening of HIV-infected men who have sex with men. Sexually Transmitted Diseases, 41(2), 137–142.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Dina Romo
    • 1
    • 2
  • Gowri Nagendra
    • 3
  • Sarah Schechter
    • 4
  • April Pavlish
    • 3
  • Alwyn Cohall
    • 5
  • Natalie Neu
    • 6
    Email author
  1. 1.Department of PediatricsColumbia University Medical CenterNew YorkUSA
  2. 2.Albert Einstein Medical CollegeBronxUSA
  3. 3.Mailman School of Public HealthColumbia UniversityNew YorkUSA
  4. 4.Department of PediatricsNewYork-Presbyterian HospitalNew YorkUSA
  5. 5.Department of Pediatrics and Mailman School of Public HealthColumbia University Medical CenterNew YorkUSA
  6. 6.Department of PediatricsColumbia University Medical CenterNew YorkUSA

Personalised recommendations