Sexually transmitted disease screening and reporting practices in a military medical center

Sexually transmitted diseases (STDs) and their sequelae are responsible for significant human and economic costs. Military personnel are one of many c ore populations at increased risk for acquiring STDs. This study was design ed to assess primary care physician/practitioner compliance with secondary screening recommendations and reporting practices of STDs in a military set ting. Data from approximately 27,000 covered lives from the Naval Hospital and the Naval Air Station Branch Medical Clinic in Jacksonville, Florida, w ere used in this analysis. Because chlamydia is the most prevalent STD, lab oratory results indicative of infection with chlamydia from July 1 to Decem ber 31, 1996, were used as a marker of a patient population requiring addit ional (secondary) STD screening. Patients with laboratory-confirmed chlamyd ia infection were identified using the Composite Health Care System. The me dical records of these index cases were then analyzed for the presence of l aboratory test results of human immunodeficiency virus (HIV), rapid plasma reagin, and hepatitis B virus (HBV) within 6 months of a positive chlamydia test, To assess compliance with mandated reporting of particular STDs, tot al laboratory-confirmed cases of chlamydia, syphilis, and HBV were compared with total cases reported to the Office of Preventive Medicine at the Bure au of Medicine and Surgery, U.S. Navy, during a 1-year period from July 1, 1996, to June 30, 1997. In 32% of chlamydia cases, no additional laboratory tests for HIV, syphilis, or HBV were obtained within 6 months. Fourteen pe rcent of chlamydia cases were reported to the Office of Preventive Medicine . Compliance with screening for multiple STDs after the identification of a single STD should be improved. In addition, better methods for reporting c ases of STDs should be implemented.