Evidence-Based Interventions Implemented into HIV Primary Care Clinics to Make Sexually Transmitted Infection Screening and Testing Routine: Outcomes of a Multi-Site Study

AIDS Patient Care STDS. 2022 Nov;36(S2):92-103. doi: 10.1089/apc.2022.0131.


In response to rising rates of bacterial sexually transmitted infections (STIs) in the United States, this evaluative study of the implementation of four evidence-based interventions was developed and implemented. In three STI and HIV high-incidence jurisdictions of the United States, nine federally funded Health Resources and Services Administration Ryan White HIV/AIDS Program clinical demonstration sites implemented (1) audio computer-assisted self-interview sexual history taking, (2) patient self-collection of urogenital and extragenital site chlamydia/gonorrhea nucleic acid amplification test specimens, (3) sexual and gender minority welcoming indicators, and (4) provider training, to make STI screening, testing, and treatment routine in their HIV primary care clinics. The priority populations of young adults, men who have sex with men, and sexual and gender minority patients were found to have risk behaviors identified in the self-interview sexual history, to prefer to self-collect urogenital and extragenital site specimens for STI testing, and to notice and like the sexual and gender minority welcoming indicators. Testing positive for a bacterial STI was significantly associated with using alcohol or recreational drugs before sex, being younger than 50 years, and having two or more sexual partners with other concurrent sexual partners. Of 255 cases of chlamydia, gonorrhea, and syphilis infections, only 13.73% of patients reported related symptoms when screened and tested.

Keywords: HIV; STI screening and testing; sexually transmitted infections.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Chlamydia Infections* / diagnosis
  • Chlamydia Infections* / epidemiology
  • Evidence-Based Medicine
  • Gonorrhea* / complications
  • Gonorrhea* / diagnosis
  • Gonorrhea* / epidemiology
  • HIV Infections* / complications
  • HIV Infections* / diagnosis
  • HIV Infections* / epidemiology
  • Homosexuality, Male
  • Humans
  • Illicit Drugs*
  • Male
  • Primary Health Care
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Sexually Transmitted Diseases* / diagnosis
  • Sexually Transmitted Diseases* / epidemiology
  • Sexually Transmitted Diseases* / prevention & control
  • Syphilis* / diagnosis
  • United States / epidemiology
  • Young Adult


  • Illicit Drugs