@article{TEXTUAL,
      recid = {5544},
      author = {Stanford, Kimberly A. and Mason, Joseph A. and Friedman,  Eleanor E.},
      title = {Trends in STI testing and diagnosis rates during the  COVID-19 pandemic at a large urban tertiary care center,  and the role of the emergency department in STI care},
      journal = {Frontiers in Reproductive Health},
      address = {2023-02-20},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Introduction: The COVID-19 pandemic has had profound  effects on access to care, including outpatient sexually  transmitted infection (STI) testing and treatment. Many  vulnerable populations already relied on the emergency  department (ED) for much of their care prior to the  pandemic. This study examines trends in STI testing and  positivity before and during the pandemic at a large urban  medical center and evaluates the role of the ED in  providing STI care.&lt;/p&gt; &lt;p&gt;Methods: This is a retrospective  review of all gonorrhea, chlamydia, and trichomonas tests  from November 1, 2018, through July 31, 2021. Demographic  information and location and results of STI testing were  extracted from the electronic medical record. Trends in STI  testing and positivity were examined for 16 month periods  before and after the COVID-19 pandemic started (March 15,  2020), with the latter divided into the early pandemic  period (EPP: March 15 -July 31, 2020) and late pandemic  period (LPP: August 1, 2020 - July 31, 2021).&lt;/p&gt;  &lt;p&gt;Results: Tests per month decreased by 42.4% during the  EPP, but rebounded by July 2020. During the EPP, the  proportion of all STI testing originating in the ED  increased from 21.4% pre-pandemic to 29.3%, and among  pregnant women from 45.2% to 51.5%. Overall STI positivity  rate increased from 4.4% pre-pandemic to 6.2% in the EPP.  Parallel trends were observed for gonorrhea and chlamydia  individually. The ED represented 50.5% of overall positive  tests, and as much as 63.1% of positive testing during the  EPP. The ED was the source of 73.4% of positive tests among  pregnant women, which increased to 82.1% during the  EPP.&lt;/p&gt; &lt;p&gt;Conclusions: STI trends from this large urban  medical center paralleled national trends, with an early  decrease in positive cases followed by a rebound by the end  of May 2020. The ED represented an important source of  testing for all patients, and especially for pregnant  patients, throughout the study period, but even more so  early in the pandemic. This suggests that more resources  should be directed towards STI testing, education, and  prevention in the ED, as well as to support linkage to  outpatient primary and obstetric care during the ED  visit.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/5544},
}