Doctors Urged To Screen for HIV and Syphilis in Women with PID

Women who suffer from PID (pelvic inflammatory disease) are at a greater risk of also contracting HIV and syphilis.

However, only a handful of adolescent females who are told they have PID in the country’s emergency departments get lab testing for syphilis and HIV.

A researching team from the Children’s National Health System looked over data from the Pediatric Health Information System. It’s a database made up of 48 U.S. children’s hospital. In a five-year period from 2010 to 2015, there were close to 10,700 PID cases diagnosed in women between the ages of 12 and 21.

There was also an increase in both syphilis and HIV cases during this time, but only 27.7 percent of the women diagnosed with PID were also screened for syphilis and 22 percent were tested for HIV and a mere 18.4 percent were tested for both diseases.

The screening rates for these diseases and others vary from hospital to hospital with some just testing two percent of the high-risk and others testing over 60 percent of the at-risk.

HIV screening is more likely in cases such as:

• Women were admitted into the hospital compared to ED discharges
• Uninsured women compared to insured women
• African-American women compared with white women
• Women who go to small hospitals (300 or fewer beds)
• Women who have public insurance instead of private insurance
• 12 to 16-year-olds compared to older adolescents

Syphilis screening is more likely in cases such as:

• Women admitted into the hospital
• African-American woman
• Women with no insurance
• Women who have public insurance
• 12 to 16-year olds

Monika Goyal, M.D. is the study’s senior author. She said 20 percent of the close to one million PID cases are diagnosed in young women in the ER. While it’s encouraging to see syphilis and HIV screening rates also increase for women with PID, there are still some missed chances to protect women’s reproductive health. She said the screening discrepancies in the 48 hospitals her team looked at shows a more standardized approach is necessary for STI screening.

Women with untreated STIs can develop PID, which can make it complicated for a woman to become pregnant. STIs can also make a woman infertile.

The Centers for Disease Control and Prevention have been urging doctors to screen women with PID positive diagnosis for HIV since 2006. They’re now recommending that they screen them for syphilis as well.

Dr. Goyal said there has been a rise in syphilis infections and is quite common in young adults. More research should lay out how EDs can improve STI screening, especially in high-risk individuals. She said innovative approach such as electronic alerts could help increase the STI screening rates for women.