Women are less likely to be tested for HIV or offered prep at time of sexually transmitted infection (STI) diagnosis, according to research results presented at the virtual Conference on Retroviruses and Opportunistic Infections, held from March 8 to 11, 2020.
Optimization of primary and secondary prevention is required to end the HIV epidemic, yet missed opportunities for HIV prevention are common. Because STIs are reliable markers of increased risk for HIV, researchers investigated missed opportunities for HIV prevention among patients who tested positive for an STI at a large academic medical center.
Positive results for gonorrhea, chlamydia, and syphilis (via the rapid plasma regain test) between January 1 and August 23, 2019 among patients aged > 18 years were identified using an electronic sexual health dashboard. Each patient was assessed with a retrospective manual chart review to evaluate demographic data, completeness of screening for STI, HIV testing and HIV prevention discussions. To assess the effect of sex on clinical outcomes, odds ratios (ORs) were calculated.
A total of 856 positive STI patient encounters among 815 patients were included in the final data analysis. The results revealed that positive tests occurred at 58 inpatient and outpatient locations. Samples from multiple anatomic sites were obtained in 7.5% of positive encounters. Of note, men were more likely to have multisite testing compared with women (20.3% vs 0.36%; OR, 69.9; 95% CI, 17.0-285.71).
Moreover, women were more likely to be inadequately screened or never screened in the previous 12 months (15.1% vs 25.8%; OR, 0.51; 95% CI, 0.35-0.74). In addition, pre-exposure prophylaxis was discussed more commonly with men than women (17% vs 1.1%; OR, 18.7; 95% CI, 7.9-44.0).
The researchers concluded that gender disparities continue to persist in HIV prevention. They recommended education and training across diverse patient care locations and specialties addressing provider practices as effective strategies to increase referral of women for comprehensive HIV prevention care.
Yumori C, Zucker J, Theodore D, Chang M, Carnevale C, Slowikowski J, et al. Women are less likely to be tested for HIV or offered prep at time of STI diagnosis. Presented at: CROI 2020. March 8-11, 2020. http://www.croiconference.org/sites/default/files/uploads/croi2020-boston-abstract-ebook.pdf. Accessed March 19, 2020.