Improving Chlamydia Risk Screening by Identifying High-Risk Service Members Using the CDC's 5 Ps Approach to Sexual Health History at a Large Military Base in North Carolina
Abstract
Background: Chlamydia Trachomatis is infecting SMs at a rate of two to three times that of the US population, with over 200,000 cases since 2010 and continuing to rise. Currently, the military only screens female SMs under the age of 25, leaving many at-risk males to go undetected. These undetected SMs can continue to transmit the disease without their knowledge. Chlamydia, when undetected, can cause severe complications and place a significant resource burden on the military health system. Clinical Question: Does using the CDC's 5 Ps assessment approach to sexual health history improve identifying high-risk behaviors and asymptomatic carriers of chlamydia when administered to all male and female SMs 30 years and younger at a large military base in NC? Project Design: Using the Iowa Model Revised EBP framework, this project incorporated a retrospective review of all G/C urine NAAT tests three months before the project's implementation phase. The 5 Ps questionnaire was implemented into daily practice through clinician engagement and education. The pre and post-implementation data were compared after the completion of the project. Analysis of Results: 449 SMs were assessed using the CDC's 5 Ps approach. The questionnaire identified 91 (20%) SMs at higher risk for STIs. Forty-five (49%) of the high-risk SMs submitted urine for G/C urine NAAT testing purposes. Consistent with the literature review, our targeted screening for high-risk SMs resulted in a 13.3% positivity rate. Five out of six (83%) positive cases were male, exposing the shortfalls in current screening practices and guidelines. Current screening practices at the site only had a 5% local positivity rate in the retrospective data review. Implications for Practice: This project was designed to improve the identification of high-risk sexual behaviors amongst male and female SMs 30 years and younger.
Document Details
- Document Type
- Technical Report
- Publication Date
- Apr 29, 2022
- Accession Number
- AD1186208
Entities
People
- Jacob A. Orrino
- Ramesh Gautam