Identifying the Demographics of Sexually Transmitted Infection Test Seekers at the Unified Government Public Health Department in Wyandotte County, Kansas

by H. Marlene Johnson

Background:

Sexually Transmitted Diseases (STDs) and Infections (STIs) are very common in the United States. It is estimated that one in two sexually active people will contract an STI by the age of 251. The majority of STDs and STIs are transmitted from person to person via oral, vaginal, or anal sexual activity2. Individuals with STDs may not always display symptoms and if they do, it may be very moderate. Due to the variation in how the symptoms are presented, many people may not know that they are infected2. Because of this, it is imperative that people get tested so that the infection can be treated appropriately and mitigate further complications. If left untreated, some STDs and STIs can cause infertility, weaken the immune system, cause cognitive defects or be passed from mother to child2.

One goal of Healthy People 2020, is to “promote healthy sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications”3. In order to address this goal, I believe that we must first identify who is seeking testing at existing clinics. From there, promoting healthy sexual behaviors, strengthening community capacity, and increasing access to quality services can be tailored to the needs of those utilizing the clinics and perhaps reallocate efforts to the people that are not utilizing existing clinics.

Action/Activity:

Research Questions:

  1. What are the characteristics of the individuals seeking tests at the Unified Government’s free Sexually Transmitted Infection Clinic?
  2. What are the characteristics of the individuals testing positive at the Unified Government’s free Sexually Transmitted Infection Clinic?

Utilizing SAS 9.4 Software, I divided the data from the Unified Government’s Sexually Transmitted Infection Clinic into single year data. I analyzed the data for each year in addition to aggregate data from all five years using PROC FREQ procedures to fill Tables 1, 2 and 3. To ensure that no individual was counted for more than once, I ran a NODUPKEY code.

Table 1: Unified Government’s STI Clinic Usage

Year 2014 2015 2016 2017 2018 All Years
Number of Tests 13592 11970 12043 12515 11420 61540
Number of Unique Individuals Tested 4448 4030 3846 3652 3207 12544
Number of Positive Tests 339 318 331 371 294 1440
Number of Non-English Speakers 25 36 44 41 39 163

Table 1 demonstrates the number of Sexually Transmitted Infection (STI) tests being done, the number of unique individuals within the community that are using the Unified Government’s free Sexually Transmitted Infection Clinic to get tested, the number of individuals with at least one positive STI test, and the number of positive individuals that do not speak English.

Table 2: Table 2: Unified Government’s STI Clinic Usage

Table 2 demonstrates the characteristics of the unique individuals that sought testing at the Unified Government’s Sexually Transmitted Infection Clinic.

Table 3: Demographics of the Unique Individuals Utilizing the STI Clinic

Table 3 demonstrates the characteristics of the unique individuals that tested positive for at least one STI at the Unified Government’s STI Clinic. Patients that sought testing in more than one year were only counted a total of one time. Over the 5 year span, there were 1653 positive tests. Out of those tests, 1440 positive tests were unique individuals.

Reflection:

After completing the beginning data analysis, I found that there were higher rates of positive STI tests among African American individuals than all other races for every year except 2017. For every year included in the analysis, women sought STI tests more than men, and single individuals sought tests more than married individuals (about ¾ of all tests were for women and ¾ of all tests were single individuals). Over the 5 year span of data, 29.10% of individuals that tested positive were considered Hispanic and 11.25% of individuals did not speak English. Generally, the highest amount of positive tests came back from the 20-24 age group. Out of all unique individuals tested, only 60.79% had the United States as their Country of Origin. 37.63% of all individuals were Hispanic. 3,370 non-English speaking individuals sought STI testing within the past 5 years and 162 tested positive for at least one STI.

By having this data analysis, the Unified Government’s STI clinic can know the type of people that are utilizing the clinic. This is important for program development, material publications, and even trainings for staff on how to approach education about STIs to these patients. In a way, just knowing these frequencies is similar to a needs assessment because the health department can use the information to better serve their community. For example, 140 individuals that tested positive over the past 5 years, spoke Spanish. If there is not always a bilingual staff member, a culturally competent staff member, or translated educational materials available, those 140 individuals are getting a lower quality of care than that of their English-speaking counterparts.

After seeing this data, the next step for me is to run a logistic regression to see if language shows an association to having a positive STI test.

  1. Cates JR, Herndon NL, Schulz S L, Darroch JE. (2004). Our voices, our lives, our futures: Youth and sexually transmitted diseases. Chapel Hill, NC: University of North Carolina at Chapel Hill School of Journalism and Mass Communication
  2. Centers for Disease Control and Prevention – STD Diseases & Related Conditions. (2016, November 4). Retrieved January 23, 2019, from https://www.cdc.gov/std/general/default.htm
  3. Sexually Transmitted Diseases. (n.d.). Retrieved January 15, 2019, from https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases
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