Online Program

Improving Capacity and Access to Sexual Health Care through Addition of Express Testing

Monday, November 2, 2015

Sarah Garwood, MD, School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Washington University, St Louis, MO
Katie Plax, M.D, Adolescent Medicine, Washington University, St Louis, MO
Gaurav Kaushik, Adolescent Medicine, Washington University, st Louis
Purpose: To evaluate the addition of express testing over a two year period in a comprehensive drop-in youth center, as a way to increase STI testing capacity and in particular increase testing for an MSM population. 

Method: Asymptomatic men and women were offered express testing over a two year period. All MSM were offered screening with urine, pharynx and rectal NAAT GC/CT testing.   

Results: From 2012 to 2014 screening rates for all STDs increased significantly for men and in particular MSM.  Urine screens for Chlamydia/Gonorrhea increased by 28% from 2168 to 2782 total screens , while screens for extra genital Chlamydia/Gonorrhea increased by 151% and 177% respectively.   Males preferred express testing. In the past 2 years out of 1726 males, 1167 accessed testing through the express option.   Of those, 422 men had at least one positive test.  Of those who were positive, 35% self-identified as MSM.  For this population, extra genital screening was performed.  Detection of Gonorrhea in the pharynx increased by 110% (21 cases to 44 cases); detection of rectal Gonorrhea increased 96% (23 cases to 45 cases).  Detection of pharyngeal Chlamydia increased 150% , while detection of rectal chlamydia increased 180% over the same time period.  Positive RPR testing for males increased 100% over the time period, and confirmatory HIV tests doubled. 

Conclusion: Express testing increased the number of youth screened with a notable increase in men and in particular MSM.  Express testing is a useful strategy to engage high risk youth populations in STI/HIV testing.

Learning Areas:

Assessment of individual and community needs for health education
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Describe increased capacity for STD testing through addition of express testing to the SPOT youth clinic. Compare data for numbers of individuals tested as well as numbers of STD positives for before and after express testing was added.

Keyword(s): Adolescents, STDs/STI

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as a physician at the SPOT, a drop-in youth center focusing on sexual and reproductive health of adolescents for 6 years.
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.