1. STI Testing among Medicaid Enrollees Initiating PrEP for HIV Prevention in Six Southern States.
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Lanier, Paul, Kennedy, Susan, Snyder, Angela, Smith, Jessica, Napierala, Eric, Talbert, Jeffrey, Hammerslag, Lindsey, Humble, Larry, Myers, Eddy, Whittington, Angel, Smith, Jheramy, Bachhuber, Marcus, Austin, Anna, Blount, Thomas, Stehlin, Grace, Fede, Ana Lopez-De, Nguyen, Hoa, Bruce, Jean, Grijalva, Carlos G., and Krishnan, Sunita
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SEXUALLY transmitted diseases , *HIV prevention , *HIV , *MEDICAID , *MEDICAL care - Abstract
The US Preventive Services Task Force has recommended offering preexposure prophylaxis (PrEP) to individuals who are at high risk of human immunodeficiency virus acquisition. Because PrEP treatment does not prevent bacterial sexually transmitted infections (STIs), Centers for Disease Control and Prevention treatment guidelines recommend STI screening for individuals taking PrEP every 3 to 6 months. No known studies estimate STI screening among individuals using PrEP in the US South, a geographic region with high rates of human immunodeficiency virus and bacterial STIs. Objectives: The purpose of this study was to measure sexually transmitted infection (STI) testing among Medicaid enrollees initiating preexposure prophylaxis (PrEP) to prevent human immunodeficiency virus. Secondary data are in the form of Medicaid enrollment and claims data in six states in the US South. Methods: Research partnerships in six states in the US South developed a distributed research network to accomplish study aims. Each state identified all first-time PrEP users in fiscal year 2017–2018 (combined N = 990) and measured the presence of STI testing for chlamydia, syphilis, and gonorrhea through 2019. Each state calculated the percentage of individuals with at least one STI test during 3-, 6-, and 12-month follow-up periods. Results: The proportion of first-time PrEP users that received an STI test varied by state: 37% to 67% of all of the individuals in each state who initiated PrEP received a test within the first 6 months of PrEP treatment and 50% to 77% received a test within the first 12 months. Conclusions: Although the Centers for Disease Control and Prevention recommends STI testing at least every 6 months for PrEP users, our analysis of Medicaid data suggests that STI testing occurs less frequently than recommended in populations at elevated risk of syphilis, gonorrhea, and chlamydia. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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