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Emergency department sexually transmitted disease and human immunodeficiency
virus screening: Findings from a national survey.
Academic Emergency Medicine 2006; 13(9):993-996.
Gift TL, Hogben Matthew.
Abstract
OBJECTIVES: To use a previously conducted national physician survey to determine
the extent of human immunodeficiency virus (HIV) and sexually transmitted
disease (STD) screening by emergency physicians compared with physicians
practicing in other settings (primary care offices, hospital ambulatory care
clinics, or other). METHODS: From the survey responses, the authors determined
the percentage of emergency physicians and physicians not practicing in EDs
screening various patient groups for syphilis, gonorrhea, chlamydia, and
HIV. Additional data from the survey (for practice location, physician gender,
and patient demographics of race and gender) were used in multivariate logistic
regressions to determine adjusted odds ratios (ORs). RESULTS: Of 3,838 survey
respondents providing answers to all questions analyzed for this study, 401
(10.5%) practiced in an emergency department. Of the remaining 3,437 physicians,
89% practiced in primary care offices or hospital ambulatory care clinics.
Based on unadjusted ORs, emergency physicians were less likely than physicians
not practicing in EDs to screen for all STDs and HIV in all patient groups
(men, nonpregnant women, and pregnant women), although the differences in
screening rates in male patients for chlamydia or gonorrhea were not significant.
The adjusted ORs varied from 0.136 (for HIV screening of pregnant women)
to 1.177 (for gonorrhea screening of pregnant women). All adjusted ORs that
were significant at p < 0.05 were < 1.0. CONCLUSIONS: Although prior
research has shown that STD and HIV rates are relatively high in emergency
department patients compared with the population as a whole, screening rates
are lower than in other settings. Addressing barriers may increase screening
rates.