241701 Frequency of STD Infection in Women Presenting to Methadone Maintenance Treatment Programs

Tuesday, November 1, 2011

Bonni Stahl, MD , Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY
Angela Jeffers, MA , Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY
Robert Roose, MD, MPH , Division of Substance Abuse, Albert Einstein College of Medicine, Bronx, NY
Janet Smith , Division of Substance Abuse, Albert Einstein College of Medicine, Bronx, NY
Sherlon Quarless , Division of Substance Abuse, Albert Einstein College of Medicine, Bronx, NY
Hillary Kunins, MD, MPH, MS , Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
Background: Chlamydia and gonorrhea (GC) screening in specific populations, including substance users, is recommended. Entry into methadone maintenance treatment (MMTP) presents an opportunity to screen a high-risk population, yet the prevalence of Chlamydia and GC infection in this population has not been well-defined. To address this gap, we began to routinely offer screening to women admitted to our Bronx MMTP.

Methods: We conducted chart reviews of consecutively admitted adult female patients from June 2010. Using a structured chart review instrument, we abstracted sociodemographic information, substance type, injection use, trauma and incarceration history, HIV status, syphilis titer, and urine GC and Chlamydia results.

Results: Forty-nine women entered treatment between June and December 2010. Eleven (22%) were Black, 32 (65%) Hispanic. Their mean age was 40 (range 24 to 57). All had heroin dependence. Thirty-one (63%) reported cocaine use. Twenty-two (45%) had injected drugs. Eleven (22%) had experienced domestic violence and 30(61%) had been incarcerated. Nine (18%) were HIV positive, and five (10%) had serologic evidence of syphilis infection. Of the 49 women, 46 (94%) were tested for GC and Chlamydia; none were positive.

Conclusions: Although women entering MMTP may be at high risk for sexually transmitted diseases, routine GC and Chlamydia testing did not identify any infections. The national U.S. prevalence of GC and Chlamydia is as high as 14% among younger minority women. The absence of GC and Chlamydia in this population suggests routine screening among older women with drug use as the sole risk factor may not be warranted.

Learning Areas:
Clinical medicine applied in public health
Program planning
Provision of health care to the public

Learning Objectives:
At the end of the session participants will be able to: Identify prevalence of Chlamydia and gonorrhea infections among women entering a methadone maintenance treatment program. Compare the prevalence rates of Chlamydia and gonorrhea infection in a study group of women enrolled in methadone maintenance treatment with prevalence rates nationally.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the MD overseeing the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Opioid Treatment: Patients, Providers, Services, and Needs
See more of: Alcohol, Tobacco, and Other Drugs