Key result
Comprehensive STI screening with HIV co-testing occurs in only ~3% of tested ED patients.
Why the study?
Patients evaluated for STIs in the emergency department are at risk for other STIs and should be screened according to CDC recommendations, but the extent of comprehensive screening was unclear.
What is the rate of comprehensive STI screening (HIV co-testing) among patients tested for STIs in the emergency department?
Observational (n=10,895)
Yes
What is the rate of comprehensive STI screening (HIV co-testing) among patients tested for STIs in the emergency department?
There is a significant gap in comprehensive HIV co-testing among patients undergoing STI screening in the emergency department, highlighting the need for targeted interventions.
ED STI evaluations rarely include recommended HIV co-testing (<3%); supports targeted QI but leaves open impact on detection without prospective trials.
Background Sexually transmitted infections (STI) are a common reason for emergency department (ED) evaluation. Patients diagnosed with or suspected to have an STI are also at risk for other STIs, and should be screened in accordance with Center for Disease Control (CDC) recommendations.Figure 1:Percentage of HIV screenings among ED patients tested for STIs Methods This study is a retrospective analysis of comprehensive STI screening conducted at eleven freestanding emergency departments associated with an academic referral center. Individuals tested for gonorrhea, chlamydia, and syphilis between 1/1/2019 and 12/31/2023 in the emergency department were evaluated for the completion of appropriate comprehensive STI screening, defined as the completion of HIV co-testing during the same ED encounter. Additional evaluation of HIV testing was also completed in higher risk individuals that tested positive for gonorrhea and/or chlamydia.Figure 2:Percentage of HIV screenings among ED patients testing positive for gonorrhea or chlamydia Results The analysis showed that comprehensive STI screening in the emergency department was completed in only 2.9% of the 10,895 patients that were screened for gonorrhea, chlamydia, or syphilis. The rate of comprehensive STI screening in the emergency department was 2.6% among the 2,082 patients that tested positive for gonorrhea and/or chlamydia. Conclusion The CDC recommends HIV screening for all persons that present for evaluation of possible sexually transmitted infections. Our analysis of individuals undergoing STI screening in the ED demonstrates a significant gap in HIV screening, including amongst higher risk individuals that have tested positive for gonorrhea and/or chlamydia. Based on these results, a comprehensive STI screening educational tool was developed within the electronic medical record to increase comprehensive STI screening. Further analysis of these interventions will be studied in the future. Disclosures Brian T. Montague, DO MS MPH, Regeneron: Grant/Research Support
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Sciarra et al. (2025) conducted an observational in Sexually transmitted infections (STI) (n=10,895). STI screening in the emergency department was evaluated on Completion of appropriate comprehensive STI screening (HIV co-testing during the same ED encounter). Comprehensive STI screening with HIV co-testing was completed in only 2.9% of 10,895 emergency department patients tested for gonorrhea, chlamydia, or syphilis.
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