Trends in Sexually Transmitted Infections in United States Ambulatory Care Clinics from 2005–2016
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data
2.2. Measures/Outcomes
2.3. Statistical Analysis
3. Results
3.1. Trends of Non-HIV STI-Related Visits
3.2. Factors Associated with STI-Related Visits
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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STI | Diagnosis Codes from HCUP’s CCSR and CCS | |
---|---|---|
ICD-9-CM | ICD-10-CM | |
Chlamydia | 076x, 078.88, 079.98, 079.88, 099.1, 099.41, 099.5x | A55x, A56x, A71x, A74x |
Gonorrhea | 098x | A54x |
Syphilis | 090x–097x | A51x–A53x |
HPV | 078.11, 795.05, 795.09, 795.15, 795.19, 796.75, 796.79 | A63.0, R85.81x, R85.82x, R87.81x, R87.82x |
Trichomoniasis | 131x | A59x |
Chancroid | 099.0 | A57x |
Genital herpes | 054.1x | A60x |
Unspecified STI | 099.9 | A64 |
Reiter’s disease | 099.3 | M02.3 |
Granuloma inguinale | 099.2 | A58 |
Year (N = Unweighted # of Visits) | 2005–2008 (N = 110) | 2009–2012 (N = 241) | 2013–2016 (N = 246) | p-Value |
---|---|---|---|---|
Weighted number of visits | 4,419,914 | 7,604,358 | 7,502,703 | N/A |
Weighted proportion of visits N% (95% CI:) | ||||
Age categories | <0.01 | |||
15–24 years | 35.3 (24.2–46.5) | 30.0 (22.0–379) | 13.9 (7.7–20.2) | |
25–44 years | 36.2 (26.0–45.5) | 50.9 (43.5–58.3) | 65.1 (55.6–74.7) | |
45–64 years | 28.4 (17.9–38.9) | 19.1 (13.2–25.0) | 20.9 (12.2–29.6) | |
Sex | 0.44 | |||
Female | 74.8 (64.7–84.8) | 64.0 (54.6–73.3) | 56.0 (44.1–68.0) | |
Male | 25.2 (15.2–35.3) * | 36.0 (26.7–45.4) | 44.0 (32.0–55.9) | |
Race | 0.03 | |||
White | 66.9 (55.6–78.1) | 69.6 (60.4–79.3) | 71.3 (61.7–80.9) | |
Black | 27.0 (15.5–38.5) | 27.4 (18.0–36.8) | 22.1 (13.3–30.8) | |
Other | 6.1 (0.9–11.4) * | 2.8 (0.4–5.1) * | 6.7 (1.4–11.9) * | |
Ethnicity | <0.01 | |||
Hispanic | 13.6 (6.9–20.2) * | 13.6 (7.1–20.2) | 19.9 (11.4–28.3) | |
Not Hispanic | 86.4 (79.8–93.0) | 86.4 (79.8–92.9) | 80.1 (71.7–88.6) | |
Insurance | <0.01 | |||
Private | 68.3 (53.6–83.0) | 62.9 (51.8–74.0) | 60.3 (48.8–71.8) | |
Medicare/Medicaid | 17.3 (5.0–29.6) | 22.4 (14.2–30.5) | 25.0 (14.4–35.6) | |
others/missing | 14.3 (3.9–24.7) | 14.7 (5.1–24.3) | 14.7 (6.1–23.3) | |
Region | 0.37 | |||
Northeast | 12.8 (5.7–20.0) | 15.3 (9.0–21.7) | 17.3 (7.9–26.7) | |
Midwest | 19.7 (8.5–30.9) | 13.3 (8.1–18.6) | 19.2 (11.3–27.1) | |
South | 47.5 (33.3–61.7) | 54.9 (45.5–64.4) | 35.7 (24.6–46.7) | |
West | 20.0 (10.3–29.6) | 16.4 (10.0–228) | 27.8 (16.0–39.6) | |
HIV diagnosis | 1.0 (0.0–3.3) * | 3.8 (0.0–8.5) * | 3.7 (0.4–7.0) * | 0.66 |
Variables | Adjusted Odds-Ratio (95% CI) |
---|---|
Year of diagnosis (ref: 2005–2008) | |
2009–2012 | 1.66 (1.20–2.30) |
2013–2016 | 1.77 (1.26–2.47) |
Patient age categories (ref: 45–65 years) | |
15–24 years | 4.45 (3.19–6.20) |
25–44 years | 3.59 (2.71–4.77) |
Sex (ref: Male) | |
Female | 0.94 (0.72–1.22) |
Race (ref: White) | |
Black | 2.41 (1.78–3.25) |
Other | 1.08 (0.63–1.84) |
Patient ethnicity (ref: Non-Hispanic or Latino) | |
Hispanic or Latino | 1.31 (0.97–1.78) |
Insurance (ref: Medicaid/Medicare) | |
Private | 0.87 (0.63–1.19) |
Others | 0.89 (0.53–1.49) |
Region (ref: Midwest) | |
Northeast | 0.93 (0.62–1.38) |
South | 1.22 (0.90–1.64) |
West | 1.12 (0.76–1.67) |
HIV vs. Non-HIV | 10.6 (5.50–20.27) |
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Unigwe, I.; Yang, S.; Song, H.J.; Lo-Ciganic, W.-H.; Hincapie-Castillo, J.; Cook, R.L.; Park, H. Trends in Sexually Transmitted Infections in United States Ambulatory Care Clinics from 2005–2016. J. Clin. Med. 2022, 11, 71. https://doi.org/10.3390/jcm11010071
Unigwe I, Yang S, Song HJ, Lo-Ciganic W-H, Hincapie-Castillo J, Cook RL, Park H. Trends in Sexually Transmitted Infections in United States Ambulatory Care Clinics from 2005–2016. Journal of Clinical Medicine. 2022; 11(1):71. https://doi.org/10.3390/jcm11010071
Chicago/Turabian StyleUnigwe, Ikenna, Seonkyeong Yang, Hyun Jin Song, Wei-Hsuan Lo-Ciganic, Juan Hincapie-Castillo, Robert L. Cook, and Haesuk Park. 2022. "Trends in Sexually Transmitted Infections in United States Ambulatory Care Clinics from 2005–2016" Journal of Clinical Medicine 11, no. 1: 71. https://doi.org/10.3390/jcm11010071
APA StyleUnigwe, I., Yang, S., Song, H. J., Lo-Ciganic, W.-H., Hincapie-Castillo, J., Cook, R. L., & Park, H. (2022). Trends in Sexually Transmitted Infections in United States Ambulatory Care Clinics from 2005–2016. Journal of Clinical Medicine, 11(1), 71. https://doi.org/10.3390/jcm11010071