STI Testing among Medicaid Enrollees Initiating PrEP for HIV Prevention in Six Southern States

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 KrishnanCaitlin Otter, Katie Horton, Naomi Seiler, William S. Pearson

Research output: Contribution to journalArticlepeer-review


Objectives The 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. Methods Research 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. Results The 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. Conclusions Although 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.

Original languageEnglish
Pages (from-to)455-463
Number of pages9
JournalSouthern Medical Journal
Issue number6
StatePublished - Jun 1 2023

Bibliographical note

Publisher Copyright:
© Lippincott Williams & Wilkins.


  • HIV
  • Medicaid
  • delivery of health care
  • health services research
  • sexually transmitted infections

ASJC Scopus subject areas

  • General Medicine


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