Most Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT) infections in men who have sex with men (MSM) are diagnosed at extragenital sites. However, testing at these sites is often lacking. The purpose of this study was to determine if a standardized questionnaire administered by physicians and clinical assistants improves documentation of sex activity and increases extragenital testing and diagnoses of GC and CT among MSM.
Methods
A standardized sexual history questionnaire was implemented on 11/1/2022. Electronic medical records of 664 MSM with human immunodeficiency virus, including 1064 encounters, were reviewed to compare preimplementation and postimplementation sexual history documentation, adequacy of documentation, extragenital GC and CT testing, and GC and CT diagnoses. Analysis included χ2 and exact tests and logistic regression adjusting for physician cluster effects.
Results
The standardized questionnaire was used by 53.7% of physicians and 85.9% of coordinators. Documentation of whether sexual activity occurred increased from 79.3% (95% confidence interval [CI], 0.758–0.828) in the preintervention pre-COVID-19 period to 95.2% (95% CI, 0.925–0.970) in the postintervention period with an adjusted odds ratio of 4.7 (95% CI, 2.7–8.8). Specific questions about anal and oral sex increased from 42.0% to 88.1% (P