{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T16:48:05Z","timestamp":1773766085964,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We performed a retrospective study of chlamydia, gonorrhea, syphilis, and human immunodeficiency virus (HIV) testing in the Veterans Health Administration (VHA) during 2019\u20132021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We determined the annual number of chlamydia, gonorrhea, syphilis, and HIV tests from 2019 through 2021 using electronic health record data. We calculated rates by age, birth sex, race, census region, rurality, HIV status, and use of preexposure prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The VHA system experienced a 24% drop in chlamydia\/gonorrhea testing, a 25% drop in syphilis testing, and a 29% drop in HIV testing in 2020 versus 2019. By the conclusion of 2021, testing rates had recovered to 90% of baseline for chlamydia\/gonorrhea, 91% for syphilis, and 88% for HIV. Declines and subsequent improvements in sexually transmitted infection (STI) testing occurred unequally across age, sex, race, and geographic groups. Testing for all 4 STIs in 2021 remained below baseline in rural Veterans. Excluding those aged &amp;lt;25 years, women experienced a steeper decline and slower recovery in chlamydia\/gonorrhea testing relative to men, but quicker recovery in HIV testing. Asian Americans and Hawaiian\/Pacific Islanders had a steeper decline and a slower recovery in testing for chlamydia\/gonorrhea. Black and White Veterans had slower recovery in HIV testing compared with other race groups. People living with HIV experienced a smaller drop in testing for syphilis compared with people without HIV, followed by a near-total recovery of testing by 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After dramatic reductions from 2019 to 2020, STI testing rates returned to near-baseline in 2021. Testing recovery lagged in rural, female, Asian American, Hawaiian\/Pacific Islander, and Black Veterans.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ofid\/ofac433","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T03:08:05Z","timestamp":1661224085000},"source":"Crossref","is-referenced-by-count":5,"title":["Sexually Transmitted Infection Testing in the National Veterans Health Administration Patient Cohort During the Coronavirus Disease 2019 Pandemic"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6488-435X","authenticated-orcid":false,"given":"Lauren A","family":"Beste","sequence":"first","affiliation":[{"name":"General Medicine Service, Veterans Affairs Puget Sound Health Care System , Seattle, Washington , USA"},{"name":"Department of Medicine, University of Washington School of Medicine , Seattle, Washington , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shimrit","family":"Keddem","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz Veterans Affairs Medical Center, Veterans Affairs Center for Health Equity Research and Promotion , Philadelphia, Pennsylvania , USA"},{"name":"Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joleen","family":"Borgerding","sequence":"additional","affiliation":[{"name":"Health Services Research and Development, Veterans Affairs Puget Sound Healthcare System , Seattle, Washington , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliott","family":"Lowy","sequence":"additional","affiliation":[{"name":"Health Services Research and Development, Veterans Affairs Puget Sound Healthcare System , Seattle, Washington , USA"},{"name":"University of Washington School of Public Health , Seattle, Washington , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Gardella","sequence":"additional","affiliation":[{"name":"Gynecology Service, Veterans Affairs Puget Sound Health Care System , Seattle, Washington , USA"},{"name":"Department of Obstetrics and Gynecology, University of Washington School of Medicine , Seattle, Washington , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"McFarland","sequence":"additional","affiliation":[{"name":"Office of Specialty Care Services, Veterans Health Administration , Washington, District of Columbia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Comstock","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Baltimore Veterans Affairs Medical Center , Baltimore, Maryland , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe Allan","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington School of Medicine , Seattle, Washington , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Puja","family":"Van Epps","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Case Western Reserve University School of Medicine , Cleveland, Ohio , USA"},{"name":"Veterans Affairs Northeast Ohio Healthcare System, Cleveland, Ohio , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Ohl","sequence":"additional","affiliation":[{"name":"Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs , Iowa City, Iowa , USA"},{"name":"Department of Medicine, University of Iowa Carver College of Medicine , Iowa City, Iowa , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald G","family":"Hauser","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Department, Veterans Affairs Connecticut Healthcare , New Haven, Connecticut , USA"},{"name":"Department of Laboratory Medicine, Yale University School of Medicine , New Haven, Connecticut , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ross","sequence":"additional","affiliation":[{"name":"Office of Specialty Care Services, Veterans Health Administration , Washington, District of Columbia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa M","family":"Maier","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Oregon Health and Science University, Portland, Oregon , USA"},{"name":"Veterans Affairs Portland Health Care System , Portland, Oregon , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"2022121311065281400_ofac433-B1","doi-asserted-by":"crossref","first-page":"e1132","DOI":"10.1016\/S2214-109X(20)30288-6","article-title":"Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries: a modelling study","volume":"8","author":"Hogan","year":"2020","journal-title":"Lancet Glob Health"},{"key":"2022121311065281400_ofac433-B2","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.3569368","article-title":"Early evidence on social distancing in response to COVID-19 in the United States","volume-title":"SSRN","author":"Andersen"},{"key":"2022121311065281400_ofac433-B3","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1136\/sextrans-2020-054688","article-title":"Love during lockdown: findings from an online survey examining the impact of COVID-19 on the sexual health of people living in Australia","volume":"97","author":"Coombe","year":"2021","journal-title":"Sex Transm Infect"},{"key":"2022121311065281400_ofac433-B4","doi-asserted-by":"publisher","DOI":"10.1101\/2020.06.09.20125609","article-title":"Changes in solo and partnered sexual behaviors during the COVID-19 pandemic: findings from a US probability survey","author":"Hensel","year":"2020","journal-title":"medRxiv"},{"key":"2022121311065281400_ofac433-B5","article-title":"Report from the field: the impact of COVID-19 on local health department HIV, STI, and hepatitis programs","author":"Spinner","year":"2020"},{"key":"2022121311065281400_ofac433-B6","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1093\/infdis\/jiab051","article-title":"Projected HIV and bacterial sexually transmitted infection incidence following COVID-19-related sexual distancing and clinical service interruption","volume":"223","author":"Jenness","year":"2021","journal-title":"J Infect Dis"},{"key":"2022121311065281400_ofac433-B7","doi-asserted-by":"crossref","first-page":"e206","DOI":"10.1016\/S2352-3018(21)00022-9","article-title":"The potential effect of COVID-19-related disruptions on HIV incidence and HIV-related mortality among men who have sex with men in the USA: a modelling study","volume":"8","author":"Mitchell","year":"2021","journal-title":"Lancet HIV"},{"key":"2022121311065281400_ofac433-B8","doi-asserted-by":"crossref","first-page":"100483","DOI":"10.1016\/j.eclinm.2020.100483","article-title":"Understanding the impact of interruptions to HIV services during the COVID-19 pandemic: a modelling study","volume":"26","author":"Jewell","year":"2020","journal-title":"EClinicalMedicine"},{"key":"2022121311065281400_ofac433-B9","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/OLQ.0000000000001380","article-title":"The estimated direct lifetime medical costs of sexually transmitted infections acquired in the United States in 2018","volume":"48","author":"Chesson","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2022121311065281400_ofac433-B10","doi-asserted-by":"crossref","first-page":"e3235","DOI":"10.1093\/cid\/ciaa1454","article-title":"Testing practices and incidence of chlamydial and gonococcal infection in the Veterans Health Administration, 2009\u20132019","volume":"73","author":"Beste","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2022121311065281400_ofac433-B11","doi-asserted-by":"crossref","first-page":"ofab030","DOI":"10.1093\/ofid\/ofab030","article-title":"Differences in syphilis incidence using a laboratory algorithm in people with and without HIV in an 11-year nationwide cohort study","volume":"8","author":"Maier","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"2022121311065281400_ofac433-B12","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1007\/s10461-021-03195-y","article-title":"COVID-19 pandemic, pre-exposure prophylaxis (PrEP) care, and HIV\/STI testing among patients receiving care in three HIV epidemic priority states","volume":"25","author":"Hill","year":"2021","journal-title":"AIDS Behav"},{"key":"2022121311065281400_ofac433-B13","doi-asserted-by":"crossref","first-page":"e94","DOI":"10.1097\/OLQ.0000000000001445","article-title":"The COVID-19 pandemic and sexually transmitted infections: where do we go from here?","volume":"48","author":"Rogers","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2022121311065281400_ofac433-B14","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/OLQ.0000000000001638","article-title":"Impact of the COVID-19 pandemic on chlamydia and gonorrhea tests performed by a large national laboratory\u2014United States, 2019 to 2020","volume":"49","author":"Tao","year":"2022","journal-title":"Sex Transm Dis"},{"key":"2022121311065281400_ofac433-B15","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.amepre.2021.03.009","article-title":"Impact of the COVID-19 pandemic on chlamydia and gonorrhea screening in the U.S","volume":"61","author":"Pinto","year":"2021","journal-title":"Am J Prev Med"},{"key":"2022121311065281400_ofac433-B16","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1097\/OLQ.0000000000001566","article-title":"Impact of the COVID-19 pandemic on Centers for Disease Control and Prevention\u2013funded sexually transmitted disease programs","volume":"49","author":"Wright","year":"2022","journal-title":"Sex Transm Dis"},{"issue":"8S","key":"2022121311065281400_ofac433-B17","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1097\/OLQ.0000000000001463","article-title":"Decreases in reported sexually transmitted infections during the time of COVID-19 in King County, WA: decreased transmission or screening?","volume":"48","author":"Berzkalns","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2022121311065281400_ofac433-B18","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1097\/OLQ.0000000000001506","article-title":"Trends in nationally notifiable sexually transmitted disease case reports during the US COVID-19 pandemic, January to December 2020","volume":"48","author":"Pagaoa","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2022121311065281400_ofac433-B19","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1377\/hlthaff.2014.0054","article-title":"Insights from advanced analytics at the Veterans Health Administration","volume":"33","author":"Fihn","year":"2014","journal-title":"Health Aff (Millwood)"},{"key":"2022121311065281400_ofac433-B20","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1097\/QAI.0000000000001598","article-title":"Medication adherence in a nationwide cohort of Veterans initiating pre-exposure prophylaxis (PrEP) to prevent HIV infection","volume":"77","author":"van Epps","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2022121311065281400_ofac433-B21","doi-asserted-by":"crossref","first-page":"e2129139","DOI":"10.1001\/jamanetworkopen.2021.29139","article-title":"Assessment of changes in US Veterans Health Administration care delivery methods during the COVID-19 pandemic","volume":"4","author":"Rose","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2022121311065281400_ofac433-B22","article-title":"Impact of COVID-19 on STDs.","author":"Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention","year":"2022"},{"key":"2022121311065281400_ofac433-B23","article-title":"Sexually transmitted infections national strategic plan for the United States: 2021\u20132025","author":"US Department of Health and Human Services","year":"2020"},{"issue":"12 Suppl","key":"2022121311065281400_ofac433-B24","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1097\/OLQ.0b013e31818f2ae1","article-title":"Access to care issues for African American communities: implications for STD disparities","volume":"35","author":"Parrish","year":"2008","journal-title":"Sex Transm Dis"},{"key":"2022121311065281400_ofac433-B25","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.amepre.2019.11.010","article-title":"Availability of safety-net sexually transmitted disease clinical services in the U.S., 2018","volume":"58","author":"Leichliter","year":"2020","journal-title":"Am J Prev Med"},{"key":"2022121311065281400_ofac433-B26","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.whi.2021.11.005","article-title":"Racial\/ethnic and sexual orientation identity differences in the receipt of a sexual history assessment from a health care provider among women in the United States","volume":"32","author":"Perez","year":"2022","journal-title":"Womens Health Issues"},{"key":"2022121311065281400_ofac433-B27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ssresearch.2015.06.020","article-title":"Disaggregating ethnoracial disparities in physician trust","volume":"54","author":"Sewell","year":"2015","journal-title":"Soc Sci Res"},{"key":"2022121311065281400_ofac433-B28","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1080\/08964289.2019.1585327","article-title":"Medical mistrust, racism, and delays in preventive health screening among African-American men","volume":"45","author":"Powell","year":"2019","journal-title":"Behav Med"},{"key":"2022121311065281400_ofac433-B29","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s11524-015-9961-4","article-title":"A qualitative study of medical mistrust, perceived discrimination, and risk behavior disclosure to clinicians by U.S. male sex workers and other men who have sex with men: implications for biomedical HIV prevention","volume":"92","author":"Underhill","year":"2015","journal-title":"J Urban Health"},{"key":"2022121311065281400_ofac433-B30","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1001\/jama.2020.11254","article-title":"COVID-19\u2019s crushing effects on medical practices, some of which might not survive","volume":"324","author":"Rubin","year":"2020","journal-title":"JAMA"},{"key":"2022121311065281400_ofac433-B31","doi-asserted-by":"crossref","first-page":"ofac274","DOI":"10.1093\/ofid\/ofac274","article-title":"Projected effects of disruptions to human immunodeficiency virus (HIV) prevention services during the coronavirus disease 2019 pandemic among Black\/African American men who have sex with men in an ending the HIV epidemic priority jurisdiction","volume":"9","author":"Labs","year":"2022","journal-title":"Open Forum Infect Dis"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofac433\/45497552\/ofac433.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/9\/12\/ofac433\/47816412\/ofac433.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/9\/12\/ofac433\/47816412\/ofac433.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,26]],"date-time":"2023-11-26T02:07:35Z","timestamp":1700964455000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofac433\/6673485"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,23]]},"references-count":31,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofac433","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,12,1]]},"published":{"date-parts":[[2022,8,23]]},"article-number":"ofac433"}}