{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:45:51Z","timestamp":1779889551819,"version":"3.53.1"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T00:00:00Z","timestamp":1640649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["U90HA32147"],"award-info":[{"award-number":["U90HA32147"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Bacterial sexually transmitted infections (STIs) continue to be a worsening public health concern in the United States (US). Though the national incidence of HIV infection has decreased over recent years, that of chlamydia, gonorrhea, and syphilis have not. Despite national recommendations on prevention, screening, and treatment of these STIs, these practices have not been standardized. Nine Health Resources and Services Administration Ryan White HIV\/AIDS Program funded clinics across 3 US jurisdictions (Florida, Louisiana, and Washington, DC), were selected as clinical demonstration sites to be evaluated in this mixed method needs assessment to inform a multi-site, multi-level intervention to evaluate evidence-based interventions to improve STI screening and testing of bacterial STIs among people with or at risk for HIV. These 3 US jurisdictions were selected due to having higher than national average incidence rates of HIV and bacterial STIs. Descriptive statistics and deductive analysis were used to assess quantitative and qualitative needs assessment data. Results indicate the following needs across participating sites: inconsistent and irregular comprehensive sexual behavior history taking within and among sites, limited routine bacterial STI testing (once\/year and if symptomatic) not in accordance with CDC recommendations, limited extragenital site gonorrhea\/chlamydia testing, limited annual training on STI-related topics including LGBTQ health and adolescent\/young adult sexual health, and limited efforts for making high-STI incidence individuals feel welcome in the clinic (primarily LGBTQ individuals and adolescents\/young adults). These findings were used to identify interventions to be used to increase routine screenings and testing for bacterial STIs.<\/jats:p>","DOI":"10.1371\/journal.pone.0261824","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T19:41:09Z","timestamp":1640720469000},"page":"e0261824","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Improving sexually transmitted infection screening, testing, and treatment among people with HIV: A mixed method needs assessment to inform a multi-site, multi-level intervention and evaluation plan"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4772-8168","authenticated-orcid":true,"given":"Kathleen","family":"Cullinen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Macsu","family":"Hill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6647-0908","authenticated-orcid":true,"given":"John","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirna","family":"Halawani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4864-692X","authenticated-orcid":true,"given":"Peijia","family":"Zha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,28]]},"reference":[{"key":"pone.0261824.ref001","author":"Centers for Disease Control and Prevention","year":"2019"},{"issue":"3","key":"pone.0261824.ref002","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1089\/apc.2013.0328","article-title":"Brief sexual histories and routine HIV\/STD testing by medical providers","volume":"28","author":"Y. Lanier","year":"2014","journal-title":"AIDS Patient Care STDS"},{"issue":"7","key":"pone.0261824.ref003","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1097\/QAD.0000000000001772","article-title":"Impact of insurance coverage on HIV transmission potential among antiretroviral therapy-treated youth living with HIV","volume":"32","author":"S. Wood","year":"2018","journal-title":"AIDS"},{"key":"pone.0261824.ref004","unstructured":"Centers for Disease Control and Prevention. \"Combating the Threat of Antibiotic-Resistant Gonorrhea.\" https:\/\/www.cdc.gov\/std\/gonorrhea\/arg\/carb.htm (accessed."},{"issue":"10","key":"pone.0261824.ref005","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1097\/OLQ.0000000000000320","article-title":"Barriers to Bacterial Sexually Transmitted Infection Testing of HIV-Infected Men Who Have Sex With Men Engaged in HIV Primary Care","volume":"42","author":"L. A. Barbee","year":"2015","journal-title":"Sex Transm Dis"},{"issue":"5","key":"pone.0261824.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6805a1","article-title":"Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020","volume":"68","author":"R. Y. Barrow","year":"2020","journal-title":"MMWR Recomm Rep"},{"key":"pone.0261824.ref007","doi-asserted-by":"crossref","DOI":"10.1016\/j.pcl.2016.07.001","article-title":"Caring for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth in Inclusive and Affirmative Environments","author":"S. E. Hadland","year":"2016"},{"key":"pone.0261824.ref008","unstructured":"The Joint Commission, \"Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community: A Field Guide,\" Oak Brook, IL., Oct. 2011. [Online]. Available: LGBTFieldGuide.pdf"},{"issue":"10","key":"pone.0261824.ref009","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1089\/apc.2009.0086","article-title":"Health system and personal barriers resulting in decreased utilization of HIV and STD testing services among at-risk black men who have sex with men in Massachusetts","volume":"23","author":"M. J. Mimiaga","year":"2009","journal-title":"AIDS Patient Care STDS"},{"key":"pone.0261824.ref010","unstructured":"AIDS Education & Training Center Program. \"Ask, Screen, Intervene: Effective Prevention in HIV Care.\" https:\/\/aidsetc.org\/resource\/ask-screen-intervene-effective-prevention-hiv-care (accessed."},{"issue":"11","key":"pone.0261824.ref011","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1093\/cid\/ciu184","article-title":"Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men\u2014STD Surveillance Network, United States, 2010\u20132012","volume":"58","author":"M. E. 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HIV Surveillance Supplemental Report","volume":"24","author":"Centers for Disease Control and Prevention","year":"2019"},{"key":"pone.0261824.ref014","author":"U.S. Department of Health and Human Services","year":"2020","journal-title":"Sexually Transmitted Infections National Strategic Plan for the United States: 2021\u20132025,"},{"issue":"9839","key":"pone.0261824.ref015","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/S0140-6736(12)60835-6","article-title":"Comprehensive clinical care for men who have sex with men: an integrated approach","volume":"380","author":"K. H. Mayer","year":"2012","journal-title":"Lancet"},{"issue":"1","key":"pone.0261824.ref016","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1521\/aeap.2014.26.1.68","article-title":"Adaptation and implementation of HoMBReS: a community-level, evidence-based HIV behavioral intervention for heterosexual Latino men in the midwestern United States","volume":"26","author":"O. 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Bernstein","year":"2016","journal-title":"Sex Transm Dis"},{"issue":"6","key":"pone.0261824.ref019","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1007\/s11606-008-0617-x","article-title":"Improving HIV screening and receipt of results by nurse-initiated streamlined counseling and rapid testing","volume":"23","author":"H. D. Anaya","year":"2008","journal-title":"J Gen Intern Med"},{"issue":"11","key":"pone.0261824.ref020","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/OLQ.0b013e3181f7d505","article-title":"Computer-assisted self interviewing in sexual health clinics","volume":"37","author":"C. K. Fairley","year":"2010","journal-title":"Sex Transm Dis"},{"issue":"2","key":"pone.0261824.ref021","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1097\/OLQ.0000000000000294","article-title":"Interventions to Improve Sexually Transmitted Disease Screening in Clinic-Based Settings","volume":"43","author":"M. M. 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St Lawrence","year":"2002","journal-title":"Am J Public Health"},{"issue":"11","key":"pone.0261824.ref024","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1097\/OLQ.0b013e318227713e","article-title":"Evaluation of self-collected versus clinician-collected swabs for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae pharyngeal infection among men who have sex with men","volume":"38","author":"A. H. Freeman","year":"2011","journal-title":"Sex Transm Dis"},{"issue":"7","key":"pone.0261824.ref025","doi-asserted-by":"crossref","first-page":"e0132776","DOI":"10.1371\/journal.pone.0132776","article-title":"Self-Collected versus Clinician-Collected Sampling for Chlamydia and Gonorrhea Screening: A Systemic Review and Meta-Analysis","volume":"10","author":"C. 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