Improving STD Screening Rates in the HIV Clinics C. Lynn Besch, MD for the LSUHSC HIV Disease Management Team.

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Presentation transcript:

Improving STD Screening Rates in the HIV Clinics C. Lynn Besch, MD for the LSUHSC HIV Disease Management Team

STD Screening - Rationale STD’s – dangerous for individuals and their communities Complications from infection Cost of treatment Interaction with HIV transmission USA – high rates of STD’s LA – high, high, high rates of STD’s Periodic STD screening recommended in HIV clinics

Chlamydia—Rates by State, United States and Outlying Areas, 2009 NOTE: The total rate of chlamydia for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was per 100,000 population.

Gonorrhea—Rates by State, United States and Outlying Areas, 2009 NOTE: The total rate of gonorrhea for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 97.8 per 100,000 population.

Primary and Secondary Syphilis—Rates by State, United States and Outlying Areas, 2009 NOTE: The total rate of primary and secondary syphilis for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 4.6 per 100,000 population.

STD Screening in the LSU HIV Clinics Objective: Increase STD screening rates to 85% Baseline data 3 rd Q 2007: 7 HIV clinics (as a group) screening rate – GC10% Chlamydia (CT) 18% Syphilis68%

Diversity of HCSD HIV Clinics size range from 200->2000 dedicated MD’s – house staff on site subspecialties or not depth of support services

STD screening – Issues Barriers / problems common to all: Identification of patients for screening Reminders for clinicians to order screening Problems with specimen collection Tracking progress Providing feedback to clinicians

STD Screening - Methods Educational programs for staff Screening charts Revision of lab ordering slips Development of standing orders or protocols Collection kits placed in clinic Giving patients specimen cups early in the clinic visit (plenty of time for collection)

CT screening – Q to Q4 2009

CT Screening Q to Q2 2011

GC screening –Q to 4Q 2009

GC screening - Q1 ‘10 to Q2 ‘11

Syphilis Screening 2008 to 2009

Syphilis Screening: Q1‘10 - Q2 ‘11

STD Screening: Results All clinics dramatically improved screening rates, especially for GC and CT Methods included educational efforts and programmatic changes Group effort with shared responsibility for improvement Success belongs to the entire clinic staff