Premium
Retrospective study of the effect of enhanced systematic sexually transmitted infection screening, facilitated by the use of electronic patient records, in an HIV ‐infected cohort
Author(s) -
Brook G,
McSorley J,
Shaw A
Publication year - 2013
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12020
Subject(s) - medicine , incidence (geometry) , syphilis , chlamydia , cohort , retrospective cohort study , men who have sex with men , human immunodeficiency virus (hiv) , cohort study , immunology , physics , optics
Objectives The aim of the study was to assess the impact of electronic checklists in enhancing sexually transmitted infection ( STI ) screening in routine HIV care. Methods This was a retrospective cohort study. In two HIV clinics, new STIs were recorded for three consecutive 12‐month periods between 2009 and 2012 in a cohort of 882 HIV ‐infected patients. These three years coincided with the introduction of enhanced STI screening based on prompts within the electronic patient record ( EPR ) system. Results The number of diagnoses and the incidence of STIs more than doubled between 2010–2011 and 2011–2012 in both men who have sex with men ( MSM ) [from 18 of 115 (15%) to 42 of 132 (32%), a rise in STI incidence from 15.6 to 31.8/100 person‐years; P < 0.001] and heterosexual patients [from six of 716 (0.8%) to 19 of 749 (2.5%), a rise in STI incidence from 0.8 to 2.5/100 person‐years; P < 0.005]. The rise was significant in MSM for infections with chlamydia [from seven of 115 (6%) to 14 of 132 (11%), a rise in incidence from 6.0 to 10.6/100 person‐years; P < 0.05], gonorrhoea [from five of 115 (4%) to 12 of 132 (9%), a rise in STI incidence from 4.3 to 9.1/100 person‐years; P < 0.05] and early syphilis [from four of 115 (3%) to 13 of 132 (10%), a rise in incidence from 3.5 to 9.8/100 person‐years; P < 0.001], but not for hepatitis C virus ( HCV ) and L ymphogranuloma venereum ( LGV ) infections. The rise was significant in heterosexual patients for infection with chlamydia [from four of 716 (0.6%) to 13 of 749 (1.7%), a rise in incidence from 0.6 to 1.7/100 person‐years; P < 0.0001] but not for gonorrhoea, syphilis or T richomonas vaginalis ( TV ). Conclusions These data show that implementing systematic, frequent and routine STI screening led to a large increase in detected STIs in this HIV ‐infected cohort. This process is greatly enhanced by the use EPRs .