Missed opportunities to assess sexually transmitted diseases in US adults during routine medical checkups

Objectives: Methods: Results: Conclusions: Although sexually transmitted di seases (STDs) cause tremendous health and economic burdens in our society, awareness and knowledge regarding STDs remain poor among health care provid ers. To examine missed opportunities for STD-related counseling, diagnosis and treatment, we investigated how frequently U.S. adults reported being as ked about STDs by their health care providers during routine checkups. Methods: We analyzed the responses of 3390 adults aged 18-64 who reported h aving a routine checkup during the past year in the 1994 U.S. National Heal th Interview Survey (NHIS), a nationally representative survey. We used a l ogistic model to determine factors that were independently associated with the likelihood of being asked about STDs during the checkup. Results: Only 28% (+/-0.9%) of respondents reported being asked about STDs during their last routine checkup. Persons were significantly more likely ( p < 0.05) to be asked about STDs if they were aged under 45, male, single, had a household income under the federal poverty level, or were insured by a health maintenance organization, public coverage or by no plan rather tha n by a fee-for-service arrangement. Conclusions: Only about one quarter of U.S. adults reported being asked abo ut STDs during routine checkups. Routine checkups in which these issues are not discussed may represent missed opportunities for STD prevention. Perso ns presenting for routine care can be counseled, screened and, if infected, can be treated. Interventions are needed at the patient, provider, and com munity levels to increase the opportunities to assess STD risk, to counsel, to diagnose, and to treat infections during routine checkups.