Implementation of a Risk Assessment Tool to Increase Screening for Extragenital Gonorrhea and Chlamydia in Men Who Have Sex with Men

INTRODUCTION: Gonorrhea and chlamydia account for the majority of sexually transmitted infections (STIs) in the United States and are often thought to infect only the urogenital tract. Infections can also be harbored at extragenital sites (rectum and oropharynx), and these infections can increase susceptibility to HIV. Extragenital screening recommendations exist for populations deemed high risk, including men who have sex with men (MSM); yet, routine screening is not consistently completed. PURPOSE: To improve screening rates for extragenital gonorrhea and chlamydia in MSM within a primary care setting by using an STI risk assessment tool. METHODS: Clinicians completed a baseline knowledge survey. Clinicians were then provided education on extragenital STI infections and how to use the risk assessment tool. The risk assessment tool was given to eligible patients during preventative and STI screening office visits. Clinicians completed a follow-up questionnaire seven weeks after the risk assessment tool was implemented. RESULTS: Clinicians reported improved knowledge base with extragenital STIs and felt more comfortable screening patients when appropriate. Clinicians reported being more likely to offer extragenital screenings using the risk assessment tool. LIMITATIONS: Limitations included the number of clinicians participating as well as a narrow population focus. This limited the ability to evaluate the risk assessment tool for effectiveness. IMPLICATIONS FOR PRACTICE: Clinicians are better equipped to consistently offer extragenital STI screening to patients when appropriate. On a larger scale, this process may reduce susceptibility to HIV and create opportunities to discuss and offer HIV prevention options such as pre-exposure prophylaxis (PrEP)