STD Testing Protocols, STD Testing, and Discussion of Sexual Behaviors in HIV Clinics in Los Angeles County. Melanie M. Taylor MD, MPH Los Angeles County STD Program. Acknowledgements. Tracie McClain MD, MPH Bessie Brown Getahun Aynalem MD, MPH Lisa Smith DrPH Peter Kerndt MD, MPH
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STD Testing Protocols, STD Testing, and Discussion of Sexual Behaviors in HIV Clinics in Los Angeles County
Melanie M. Taylor MD, MPH
Los Angeles County STD Program
*Office of AIDS Programs and Policy. Los Angeles County Department of Health Services. HIV Prevention Plan Addendum. 2003
In-person or phone interview performed by one interviewer
17 Question Survey
Results analyzed using SPSS
Patient information cards for 6 STDs,
CA STD treatment guidelines,
MMWR: Prevention for Positives,
Posters of primary and secondary syphilis symptoms,
STD reporting forms
Clinician Type% of Sample
Clinic Directors 3
HIV/AIDS Program Coordinators11
Physician’s Assistants 3
Medical Assistant 3
Community Based Organization
Source: LAC DHS STD Program; N=44,205
When asked about LA syphilis rates,
100% spontaneously reported they were higher.
97% thought they were higher than the national average.
STD TestNumber (%)
HPV (Pap Smears)7 (15)
Hepatitis screen (A, B, C)48 (100)
Clinical PracticeNumber (%)
Use of STD testing protocol 24 (50)
Protocol Based on:
CDC Guidelines3 (13)
LAC STD Program
Screening Recommendations 4 (17)
Sexual Risk Assessment 9 (38)
ActivityWP Use WP Non-UseOR(95%CI)P Value
Every 3-6 months:
Syphilis 20 (83)14 (58)3.6 (0.9-13.7)0.055
GC/CT 7 (79)6 (25)1.2 (0.3-4.4)0.5
Patients asked about unsafe sex behavior at each visit
24 (100)0 (0)2.2 (1.4-3.4)<0.001
Clinic Type WP UseWP Non-UseOR (95% CI)P Value
Program** 22 (92) 11 (46)13.0 (2.5-68.1)0.001
CBO15 (63) 0 (0)2.7 (1.6-4.5)<0.001
HMO0 (0) 7 (29)0.7 (0.5-0.9)0.009
Hosp/Univ2 (8) 3 (13)0.6 (0.1-4.2)1.0
Private2 (8) 9 (38)0.2 (0.03-0.8)0.04
Public5 (21) 5 (21)1.0 (0.2-4.0)0.6
-Have you practiced unsafe/unprotected (without a condom) sex since your last visit?
-Have you have unprotected oral, anal, or vaginal sex since your last visit?
-Do/did you use a condom when you have/had sex?
-If unsafe sex, what was the HIV status of your partner(s)?
-If unsafe sex, was your partner(s) aware of your HIV status?
-Have you used any recreational drugs that were linked to your sexual activity?
-Was your sexual interaction with an anonymous partner(s)? If anonymous, where did the sexual interaction take place? (bathhouse, sex club, via internet contact, other)
-What type of sex practices do/did you engage in?
-Have you had sex with men, women or both?