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Do Clinicians Screen Medicaid Patients for Syphilis or HIV When They Diagnose Other Sexually Transmitted Diseases?

RUST, GEORGE MD, MPH*; MINOR, PATRICK MSPH*; JORDAN, NEIL PhD; MAYBERRY, ROBERT PhD; SATCHER, DAVID MD, PhD*

doi: 10.1097/01.OLQ.0000078652.66397.4C
Article

Background Patients diagnosed with gonorrhea or chlamydia are at high risk for HIV and syphilis, and should be offered screening for both.

Goal This study measures HIV and syphilis screening rates among Medicaid patients diagnosed with another sexually transmitted disease (STD).

Study Design Using 1998 Medicaid claims data from 4 states, we identified individuals diagnosed with gonorrhea, urogenital chlamydia, or pelvic inflammatory disease, and then measured the proportion receiving screening tests for HIV and syphilis.

Results Only 25% of STD-diagnosed Medicaid patients received screening tests for syphilis and only 15% for HIV. We found significant state-to-state variability in screening rates.

Conclusion Medicaid patients diagnosed with a nonbloodborne STD represent a high-risk group that is not adequately screened for syphilis and HIV despite repeated contact with medical professionals. Interventions should focus on eliminating missed opportunities for screening these high-risk individuals.

In the four states studied, (GA, IN, NJ, and WA), only 25% of STD-diagnosed Medicaid patients received screening tests for syphilis, and only 15% for HIV. We found significant state-to-state variability in screening rates.

From the *National Center for Primary Care at Morehouse School of Medicine, Atlanta, Georgia; the Department of Mental Health Law & Policy, Florida Mental Health Institute, University of South Florida, Tampa, Florida; and the Program for Healthcare Effectiveness Research, Morehouse School of Medicine, Atlanta, Georgia

Correspondence: George Rust, MD, MPH, National Center for Primary Care at Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310. E-mail: RustG@msm.edu

Received January 27, 2003,

revised April 18, 2003, and accepted May 2, 2003.

© Copyright 2003 American Sexually Transmitted Diseases Association