LEEP procedures present an important STI screening opportunity

CHICAGO – Many women who undergo a loop electrosurgical excision procedure for advanced cervical dysplasia are not screened for HIV and other sexually transmitted diseases, according to findings from a records review.

"While younger women were more likely to have been screened for HIV and other STIs than older women in this cohort, all women presenting for LEEP should be counseled and offered screening if indicated," investigators reported in a poster at the annual meeting of the American Congress of Obstetricians and Gynecologists. Ob.gyn. providers should not assume that screening is routinely offered in the primary care setting, they added.

Of 95 women who underwent LEEP at a large, urban university clinic between January 2010 and December 2012, 52 (55%) had no screening for HIV, syphilis, chlamydia, or gonorrhea within 12 months of the procedure or between their most recent Pap smear and the LEEP procedure, and 43 had at least one STI screening, Nicholas O. Jeffrey, a medical student at Florida State University, Tallahassee, and his associates reported.

Older women were less likely than younger women in this cohort to be screened; the mean age of women with no documented STI or HIV screening test was 43 years, compared with 33 years among those who were screened, Mr. Jeffrey found.

Those with no testing had at least two visits within the year prior to their LEEP procedure, they noted.

"Ob.gyn. providers have a unique opportunity to recommend and offer HIV and STI screening to women seeking treatment for abnormal cervical cytology, because these women often have more than one [gynecologic] visit during treatment," they wrote.

Based on these findings, the opportunity is often missed.

HIV and STI screening are important public health interventions because the incidence of HIV and STIs continues to rise, particularly among minority women in urban areas. In fact, the U.S. Preventive Services Task Force recommends HIV screening for those who have not been tested or who are at increased risk of HIV or other STIs.

Most invasive and preinvasive lesions of the cervix and vagina are caused by human papillomavirus types 16 and 18, and because HPV is transmitted through sexual contact, screening for other STIs is warranted in women who present with HPV infection.

Furthermore, having an STI increases the risk of acquiring HIV infection, Mr. Jeffrey and his colleagues noted, adding that as detection of HPV-related diseases advances, the number of women accessing the health care system for treatment will likely increase.

Mr. Jeffrey reported having no disclosures.

CHICAGO – Many women who undergo a loop electrosurgical excision procedure for advanced cervical dysplasia are not screened for HIV and other sexually transmitted diseases, according to findings from a records review.

"While younger women were more likely to have been screened for HIV and other STIs than older women in this cohort, all women presenting for LEEP should be counseled and offered screening if indicated," investigators reported in a poster at the annual meeting of the American Congress of Obstetricians and Gynecologists. Ob.gyn. providers should not assume that screening is routinely offered in the primary care setting, they added.

Of 95 women who underwent LEEP at a large, urban university clinic between January 2010 and December 2012, 52 (55%) had no screening for HIV, syphilis, chlamydia, or gonorrhea within 12 months of the procedure or between their most recent Pap smear and the LEEP procedure, and 43 had at least one STI screening, Nicholas O. Jeffrey, a medical student at Florida State University, Tallahassee, and his associates reported.

Older women were less likely than younger women in this cohort to be screened; the mean age of women with no documented STI or HIV screening test was 43 years, compared with 33 years among those who were screened, Mr. Jeffrey found.

Those with no testing had at least two visits within the year prior to their LEEP procedure, they noted.

"Ob.gyn. providers have a unique opportunity to recommend and offer HIV and STI screening to women seeking treatment for abnormal cervical cytology, because these women often have more than one [gynecologic] visit during treatment," they wrote.

Based on these findings, the opportunity is often missed.

HIV and STI screening are important public health interventions because the incidence of HIV and STIs continues to rise, particularly among minority women in urban areas. In fact, the U.S. Preventive Services Task Force recommends HIV screening for those who have not been tested or who are at increased risk of HIV or other STIs.

Most invasive and preinvasive lesions of the cervix and vagina are caused by human papillomavirus types 16 and 18, and because HPV is transmitted through sexual contact, screening for other STIs is warranted in women who present with HPV infection.

Furthermore, having an STI increases the risk of acquiring HIV infection, Mr. Jeffrey and his colleagues noted, adding that as detection of HPV-related diseases advances, the number of women accessing the health care system for treatment will likely increase.

Mr. Jeffrey reported having no disclosures.

CHICAGO – Many women who undergo a loop electrosurgical excision procedure for advanced cervical dysplasia are not screened for HIV and other sexually transmitted diseases, according to findings from a records review.

"While younger women were more likely to have been screened for HIV and other STIs than older women in this cohort, all women presenting for LEEP should be counseled and offered screening if indicated," investigators reported in a poster at the annual meeting of the American Congress of Obstetricians and Gynecologists. Ob.gyn. providers should not assume that screening is routinely offered in the primary care setting, they added.

Of 95 women who underwent LEEP at a large, urban university clinic between January 2010 and December 2012, 52 (55%) had no screening for HIV, syphilis, chlamydia, or gonorrhea within 12 months of the procedure or between their most recent Pap smear and the LEEP procedure, and 43 had at least one STI screening, Nicholas O. Jeffrey, a medical student at Florida State University, Tallahassee, and his associates reported.

Older women were less likely than younger women in this cohort to be screened; the mean age of women with no documented STI or HIV screening test was 43 years, compared with 33 years among those who were screened, Mr. Jeffrey found.

Those with no testing had at least two visits within the year prior to their LEEP procedure, they noted.

"Ob.gyn. providers have a unique opportunity to recommend and offer HIV and STI screening to women seeking treatment for abnormal cervical cytology, because these women often have more than one [gynecologic] visit during treatment," they wrote.

Based on these findings, the opportunity is often missed.

HIV and STI screening are important public health interventions because the incidence of HIV and STIs continues to rise, particularly among minority women in urban areas. In fact, the U.S. Preventive Services Task Force recommends HIV screening for those who have not been tested or who are at increased risk of HIV or other STIs.

Most invasive and preinvasive lesions of the cervix and vagina are caused by human papillomavirus types 16 and 18, and because HPV is transmitted through sexual contact, screening for other STIs is warranted in women who present with HPV infection.

Furthermore, having an STI increases the risk of acquiring HIV infection, Mr. Jeffrey and his colleagues noted, adding that as detection of HPV-related diseases advances, the number of women accessing the health care system for treatment will likely increase.

Mr. Jeffrey reported having no disclosures.