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Missed opportunities to assess sexually transmitted diseases in
U.S. adults during routine medical checkups.
American Journal of Preventive Medicine 2000;18(2):109-114.
Tao G, Irwin KL, Kassler WJ.
Abstract
OBJECTIVES: Although sexually transmitted diseases (STDs) cause tremendous
health and economic burdens in our society, awareness and knowledge regarding
STDs remain poor among health care providers. To examine missed opportunities
for STD-related counseling, diagnosis and treatment, we investigated how
frequently U.S. adults reported being asked about STDs by their health care
providers during routine checkups. METHODS: We analyzed the responses of
3390 adults aged 18-64 who reported having a routine checkup during the past
year in the 1994 U.S. National Health Interview Survey (NHIS), a nationally
representative survey. We used a logistic model to determine factors that
were independently associated with the likelihood of being asked about STDs
during the checkup. RESULTS: Only 28% (+/-0.9%) of respondents reported being
asked about STDs during their last routine checkup. Persons were significantly
more likely (p<0.05) to be asked about STDs if they were aged under 45,
male, single, had a household income under the federal poverty level, or
were insured by a health maintenance organization, public coverage or by
no plan rather than by a fee-for-service arrangement. CONCLUSIONS: Only about
one quarter of U.S. adults reported being asked about STDs during routine
checkups. Routine checkups in which these issues are not discussed may represent
missed opportunities for STD prevention. Persons presenting for routine care
can be counseled, screened and, if infected, can be treated. Interventions
are needed at the patient, provider, and community levels to increase the
opportunities to assess STD risk, to counsel, to diagnose, and to treat infections
during routine checkups.