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Chlamydia and Gonorrhea Testing Patterns Among Women with and Without Serious Mental Illness

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Abstract

Rates of the sexually transmitted infections (STIs) Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) have risen in women by 13% and 40%, respectively, since 2015. Women with Serious Mental Illness (SMI) are at disproportionate risk for STIs. A retrospective chart review was performed at a safety-net healthcare system in the Southeastern United States (US) from 2014 to 2017. CT/GC positivity rates did not differ between the general and SMI populations (6.6% vs. 6.5% for CT and 1.8% vs. 2.2% for GC, respectively). Emergency Medicine accounted for more positive STI test results in SMI patients than the general population (25.2% vs. 19.1% for CT, 47.8% vs. 35.5% for GC, respectively). SMI patients received large portions of STI care in emergency settings, where follow-up is poor. Point of Care (POC) testing could improve care in this setting, and mental healthcare providers must address sexual health with patients who otherwise may not receive this care.

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References

  • Abel, K., & Rees, S. (2010). Reproductive and sexual health of women service users: What’s the fuss?: Commentary on… addressing the sexual and Reproductive Health needs of women who use Mental Health Services. Advances in Psychiatric Treatment, 16(4), 279–280.

    Article  Google Scholar 

  • Chesson, H. W., Spicknall, I. H., Bingham, A., Brisson, M., Eppink, S. T., Farnham, P. G., Kreisel, K. M., et al. (2021). The estimated direct Lifetime Medical costs of sexually transmitted infections acquired in the United States in 2018. Sexually Transmitted Diseases, 48(4), 215–221.

    Article  PubMed  Google Scholar 

  • Commissioner, O. (2021, March 31). of the. FDA Allows for First Point-of-Care Chlamydia and Gonorrhea Test to be Used in More Near-Patient Care Settings. FDA. FDA. Retrieved March 23, 2022, from https://www.fda.gov/news-events/press-announcements/fda-allows-first-point-care-chlamydia-and-gonorrhea-test-be-used-more-near-patient-care-settings

  • Dawkins, M., Bishop, L., Walker, P., Otmaskin, D., Ying, J., Schmidt, R., Harnett, G., et al. (2021). Clinical integration of a highly accurate PCR point-of-care test can inform Immediate Treatment decisions for Chlamydia, Gonorrhea and Trichomonas. Sexually Transmitted Diseases.

  • De Hert, M., Correll, C. U., Bobes, J., Cetkovich-Bakmas, M., Cohen, D., Asai, I., Detraux, J., et al. (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry, 10(1), 52–77.

    Article  PubMed  Google Scholar 

  • Druss, B. G., Chwastiak, L., Kern, J., Parks, J. J., Ward, M. C., & Raney, L. E. (2018). Psychiatry’s role in improving the Physical Health of Patients with Serious Mental illness: A Report from the american Psychiatric Association. Psychiatric Services, 69(3), 254–256. American Psychiatric Publishing.

    Article  PubMed  Google Scholar 

  • Essock, S. M., Dowden, S., Constantine, N. T., Katz, L., Swartz, M. S., Meador, K. G., Osher, F. C. (2003). Blood-Borne Infections and Persons With Mental Illness: Risk Factors for HIV, Hepatitis B, and Hepatitis C Among Persons With Severe Mental Illness. Psychiatric Services, 54(6), 836–841. American Psychiatric Publishing.

  • Glasgow, K. E. (2020). Lack of sexually transmitted infection treatment accuracy when relying on Syndromic Management in an urgent care setting. Sexually Transmitted Diseases, 47(9), 625–627.

    Article  PubMed  Google Scholar 

  • Higgins, A., Barker, P., & Begley, C. M. (2006). Sexual health education for people with mental health problems: What can we learn from the literature? Journal of Psychiatric and Mental Health Nursing, 13(6), 687–697.

    Article  CAS  PubMed  Google Scholar 

  • Holley, C. E., Van Pham, T., Mezzadra, H. M., Willis, G. C., & Witting, M. D. (2015). Overtreatment of gonorrhea and chlamydial infections in 2 inner-city emergency departments. The American Journal of Emergency Medicine, 33(9), 1265–1268.

    Article  PubMed  Google Scholar 

  • Hope, H., Pierce, M., Johnstone, E. D., Myers, J., & Abel, K. M. (2022). The sexual and reproductive health of women with mental illness: A primary care registry study. Archives of Women’s Mental Health, 25(3), 585–593.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hughes, E., Bassi, S., Gilbody, S., Bland, M., & Martin, F. (2016). Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness: A systematic review and meta-analysis. The Lancet Psychiatry, 3(1), 40–48.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jenkins, W. D., Zahnd, W., Kovach, R., & Kissinger, P. (2013). Chlamydia and gonorrhea screening in United States emergency departments. The Journal of Emergency Medicine, 44(2), 558–567.

    Article  PubMed  Google Scholar 

  • Khan, M. R., Kaufman, J. S., Pence, B. W., Gaynes, B. N., Adimora, A. A., Weir, S. S., & Miller, W. C. (2009). Depression, sexually transmitted infection, and sexual risk behavior among young adults in the United States. Archives of Pediatrics & Adolescent Medicine, 163(7), 644–652.

    Article  Google Scholar 

  • King, C., Feldman, J., Waithaka, Y., Aban, I., Hu, J., Zhang, S., Hook, E. I., et al. (2008). Sexual risk behaviors and sexually transmitted infection prevalence in an Outpatient Psychiatry Clinic. Sexually Transmitted Diseases, 35(10), 877–882.

    Article  PubMed  Google Scholar 

  • Lawley, M. E., Cwiak, C., Cordes, S., Ward, M., & Hall, K. S. (2022). Barriers to Family Planning Among Women With Severe Mental Illness. Women’s Reproductive Health, 0(0), 1–19. Taylor & Francis.

  • Meade, C. S., & Sikkema, K. J. (2005). HIV risk behavior among adults with severe mental illness: A systematic review. Clinical Psychology Review, 25(4), 433–457.

    Article  PubMed  Google Scholar 

  • Miller, E., Lasser, K. E., & Becker, A. E. (2007). Breast and cervical cancer screening for women with mental illness: Patient and provider perspectives on improving linkages between primary care and mental health. Archives of Women’s Mental Health, 10(5), 189–97. New York, Netherlands: Springer Nature B.V.

  • Mizock, L., & Brubaker, M. (2021). Treatment experiences with gender and discrimination among women with serious mental illness. Psychological Services, 18(1), 64–72.

    Article  PubMed  Google Scholar 

  • Morris, S. R., Bristow, C. C., Wierzbicki, M. R., Sarno, M., Asbel, L., French, A., Gaydos, C. A., et al. (2021). Performance of a single-use, rapid, point-of-care PCR device for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis: A cross-sectional study. The Lancet Infectious Diseases, 21(5), 668–676.

    Article  CAS  PubMed  Google Scholar 

  • Niedzwiecki, M. J., Sharma, P. J., Kanzaria, H. K., McConville, S., & Hsia, R. Y. (2018). Factors Associated with Emergency Department Use by patients with and without Mental Health Diagnoses.JAMA network open, 1(6), e183528.

  • Pearson, W. S., Peterman, T. A., & Gift, T. L. (2017). An increase in sexually transmitted infections seen in US emergency departments. Preventive Medicine, 100, 143–144.

    Article  PubMed  Google Scholar 

  • Quinn, C., Happell, B., & Browne, G. (2012). Opportunity lost? Psychiatric medications and problems with sexual function: A role for nurses in mental health. Journal of Clinical Nursing, 21(3–4), 415–423.

    Article  PubMed  Google Scholar 

  • Ronaldson, A., Elton, L., Jayakumar, S., Jieman, A., Halvorsrud, K., & Bhui, K. (2020). Severe mental illness and health service utilization for nonpsychiatric medical disorders: A systematic review and meta-analysis.PLoS medicine, 17(9), e1003284.

  • Foreword—Sexually Transmitted Disease Surveillance, 2019. (2021, April 14). Retrieved September 7, 2021, from https://www.cdc.gov/std/statistics/2019/foreword.htm

  • National Overview—Sexually Transmitted Disease Surveillance, 2019. (2021, April 19). Retrieved September 7, 2021, from https://www.cdc.gov/std/statistics/2019/overview.htm

  • Ranking the States. (n.d.). Mental Health America. Retrieved June 17 (2022). from https://www.mhanational.org/issues/ranking-states

  • Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders. Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2021, SAMHSA Publication No. PEP21-06-02-001. Retrieved June 17 (2022). from https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP21-06-02-001.pdf

  • Table 3. Chlamydia—Reported Cases and Rates of Reported Cases by State/Territory and Region in Alphabetical Order, United States, 2015–2019. (2022, April 12). Retrieved June 17, 2022, from https://www.cdc.gov/std/statistics/2019/tables/3.htm

  • Table 14. Gonorrhea—Reported Cases and Rates of Reported Cases by State/Territory and Region in Alphabetical Order, United States, 2015–2019. (2022, April 12). Retrieved June 17, 2022, from https://www.cdc.gov/std/statistics/2019/tables/14.htm

  • Zatloff, J. P., von Esenwein, S. A., Philip, Z., & Ward, M. C. (2020). Navigating a Complex Health System: The Perceptions of Psychiatric Residents in Addressing Sexual and Reproductive Health of Women with Severe Mental Illness. Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 44(4), 403–407.

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Authors and Affiliations

  1. Emory University School of Medicine, Atlanta, GA, USA

    Samantha L. Karlow

  2. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Samantha R. Levano

  3. Center for Public Partnerships and Research, University of Kansas, Lawrence, KS, USA

    Silke A. von Esenwein

  4. Department of Psychiatry and Behavioral Sciences, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Martha C. Ward

  5. Jane Fonda Center, Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA

    Megan McCool-Myers

  6. Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA

    Megan E. Lawley

  7. University of Missouri - Kansas City, 2301 Holmes Street, Kansas City, MO, 64108, USA

    Samantha L. Karlow

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  1. Samantha L. Karlow
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  2. Samantha R. Levano
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  3. Silke A. von Esenwein
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Correspondence to Samantha L. Karlow.

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Karlow, S.L., Levano, S.R., von Esenwein, S.A. et al. Chlamydia and Gonorrhea Testing Patterns Among Women with and Without Serious Mental Illness. Community Ment Health J 59, 1490–1497 (2023). https://doi.org/10.1007/s10597-023-01134-w

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