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Background An estimated 21% of 1.1 million HIV-infected US residents do not know they are infected and may unknowingly transmit HIV. Because people with sexually transmitted diseases (STDs) are at increased risk of HIV, CDC recommends HIV screening for patients seeking STD treatment. We investigated whether patients given a diagnosis of Neisseria gonorrhoeae during January 2009-June 2010 were concurrently tested for HIV. Methods We used data from interviews with randomly selected gonorrhoea-infected patients in the 12 state and local health jurisdictions constituting the STD Surveillance Network. We compared the prevalence of HIV testing concurrent with gonorrhoea testing or treatment among patients seeking care in STD clinics and patients in other practice settings (emergency rooms, public and private outpatient facilities, hospitals, and family planning clinics). Results Of 6658 eligible patients, 3462 (52%) were successfully interviewed. Complete data were available for 1845/3462 (53%). Of these, 51% were tested for HIV when they were tested or treated for gonorrhoea. The proportion of gonorrhoea patients tested for HIV ranged from 22% to 74% by jurisdiction. STD clinic patients were more likely to be tested for HIV than those in other practice settings (61% vs 46%, p Conclusions HIV testing among gonorrhoea-infected patients is sub-optimal. While patients are more likely to be HIV-tested in STD clinics than in other practice settings, even STD clinics miss many opportunities to test high risk groups such as MSM, who are less likely than women to be HIV tested in this setting. Interventions are urgently needed to increase HIV testing among STD patients.

Background STD clinics routinely provide diagnostic and treatment services for anogenital warts. With the availability and increasing use of a highly effective quadrivalent vaccine against the HPV types associated with 90% of anogenital warts, the impact on patients presenting with anogenital warts to STD clinics may be significant. To be positioned to estimate the population-level impact of HPV vaccine on STD clinics, we conducted a baseline cross sectional analysis of patients with anogenital wart-related visits. Methods We reviewed STD clinic data collected on patients seen by a clinician from 1 January 2010 to 30 September 2010 in 11 sites (38 clinics) participating in the STD Surveillance Network (SSuN)—Seattle, WA (1 clinic); San Francisco, CA (1); Los Angeles, CA (12); Denver, CO (1); Chicago, IL (5); New Orleans, LA (1); Birmingham, AL (1); Richmond, VA (3); Baltimore, MD (2); Philadelphia, PA (2); New York City, NY (9). SSuN uses a collaboratively developed protocol to collect demographic, risk behaviour, and clinical data on all patients with anogenital warts at participating STD clinics. The unit of analysis was unique patients; patients were considered to have anogenital warts if warts were identified at any visit. Results Among SSuN sites, 3–13% (median 4%) of STD clinic patients had anogenital wart-related visits, with 5063 patients presenting for 6989 visits. Among patients with anogenital warts, 20% of the patients had multiple anogenital warts-related visits (range 2–26 visits). Overall, the median prevalence rate was 2% (range 1–5%) for women and 6% (range 4–22%) for men. By age and sex, median prevalence rates were highest among women aged 20–24 at 3% (range 1–7%) and among men aged 25–29 at 8% (range 5–25%). Among men who have sex with men (MSM), the median prevalence was 7% (range 4–18%) and among men who have sex with women only (MSW) it was 6% (range 3–23%). Of patients with anogenital warts, 40% were African American, 32% were white, 21% were Hispanic compared to all clinic patients who were 58% African American, 18% white, and 18% Hispanic. 59% received treatment and most treatment (97%) was provider applied. Conclusions The prevalence of anogenital warts among women is low in STD clinics. It may thus be difficult to monitor the impact of the HPV vaccine in women in these settings. However, the higher prevalence in MSM and MSW suggest that these clinics may provide settings in which to monitor anogenital warts in men.