86 Sexually Transmitted Infection Testing and Prevalence at a Large, Urban Hospital Before and After the SARS-CoV-19 Pandemic

Abstract

Study Objectives To determine whether behavior changes made during the SARS-CoV-19 pandemic impacted the number of patients being tested and the positivity rate of sexually transmitted infections (STI) at a large, urban hospital in the Bronx to identify how to improve the sexual health services available to our patients. Methods A retrospective, cross-sectional study using data from the EMR at a public hospital in the Bronx, New York. Included patients were aged 13 and over that had STI testing from Aug. 1, 2019 to Feb. 1, 2020 (Period 1) and Aug. 1, 2020 to Feb. 1, 2021 (Period 2) in any hospital setting. Periods 1 and 2 are 6 month periods before and after the SARS-CoV-19 pandemic in NYC, respectively. Counts and percents were used to quantify STI tests (HIV point of care, HIV 4th generation serum, Gonorrhea Amplification, Chlamydia Amplification, and Treponema Pallidum Ab screen) and positive results during Period 1 vs. Period 2. A chi-squared test of independence determined significance of positivity rates in Period 1 vs Period 2 with a p-value of .05. Results In Period 1, there were 11,752 distinct patients, 33,183 total STI tests, and a mean age of 38 years (S.D. ± 16). They were 58% female, 18% male, and 23% unknown or other self-identified sex. Period 2 had 10,313 distinct patients, 29,797 total STI tests, and a mean age of 37 years (S.D. ± 16). They were 51% female, 18% male, and 31% unknown or other self-identified sex. As described in Table 1, fewer tests were done in Period 2 than Period 1 for all STI categories at our hospital. Gonorrhea had a significantly increased positivity rate in Period 2 than Period 1. There were no significant differences in positivity rates for other STIs between the two time periods. Conclusion A lower number of STI tests was done at our hospital in Period 2 vs. Period 1. This may be due to a fear of using health care resources during the pandemic. Gonorrhea positivity rates were higher in Period 2 than Period 1, with no difference for other STIs. A stable or increased positivity rate could imply that despite new SARS-CoV-19 guidelines on social behavior, patients in our population continued to engage in condomless sexual relations. The pandemic may lead to an increase in undiagnosed STIs in the community due to decreased testing; therefore, a special focus should be placed on increasing testing availability. The emergency department is an ideal environment given readily available testing and treatment.