• Paul Lanier, Susan Kennedy, Angela Snyder, Jessica Smith, Eric Napierala, Jeffrey Talbert, Lindsey Hammerslag, Larry Humble, Eddy Myers, Angel Whittington, Jheramy Smith, Marcus Bachhuber, Anna Austin, Thomas Blount, Grace Stehlin, Ana Lopez-De Fede, Hoa Nguyen, Jean Bruce, Carlos G Grijalva, Sunita Krishnan, Caitlin Otter, Katie Horton, Naomi Seiler, and William S Pearson.
• From the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
• South. Med. J. 2023 Jun 1; 116 (6): 455463455-463.

ObjectivesThe purpose of this study was to measure sexually transmitted infection (STI) testing among Medicaid enrollees initiating preexposure prophylaxis (PrEP) to prevent human immunodeficiency virus. Secondary data are in the form of Medicaid enrollment and claims data in six states in the US South.MethodsResearch partnerships in six states in the US South developed a distributed research network to accomplish study aims. Each state identified all first-time PrEP users in fiscal year 2017-2018 (combined N = 990) and measured the presence of STI testing for chlamydia, syphilis, and gonorrhea through 2019. Each state calculated the percentage of individuals with at least one STI test during 3-, 6-, and 12-month follow-up periods.ResultsThe proportion of first-time PrEP users that received an STI test varied by state: 37% to 67% of all of the individuals in each state who initiated PrEP received a test within the first 6 months of PrEP treatment and 50% to 77% received a test within the first 12 months.ConclusionsAlthough the Centers for Disease Control and Prevention recommends STI testing at least every 6 months for PrEP users, our analysis of Medicaid data suggests that STI testing occurs less frequently than recommended in populations at elevated risk of syphilis, gonorrhea, and chlamydia.

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