2026/04/25 by Kyla Sherwood, Neil Zhang, H. David +4 · 1 voice
Medicine · Immunology and Microbiology · #Syphilis Diagnosis and Treatment #Reproductive tract infections research #HIV/AIDS Research and Interventions
paper · doi:10.1093/cid/ciag289
openalex publication_date 2026/04/25 · openalex created_date 2026/04/30 · openalex updated_date 2026/06/18
To the Editor—We read with great interest the recent article by Seibert et al. , “Increasing HIV Testing During Gonorrhea and Chlamydia Evaluations in Urgent Care and Emergency Departments” [1]. Their diagnostic stewardship intervention, which combined provider education, electronic health record (EHR) alerts, and infectious diseases–led linkage to care support, demonstrated a measurable increase in human immunodeficiency virus (HIV) co-testing among people being tested for gonorrhea or chlamydia, with approximately a 12% increase in both urgent care and emergency department (ED) settings. Importantly, 17 people were newly diagnosed with HIV, of whom 29% were identified as a direct result of the study's intervention prompts. Their work highlights the importance of HIV co-testing among people being tested for gonorrhea and chlamydia in urgent care and ED settings, while also demonstrating the persistent gaps in HIV testing in these clinical settings. We would like to further support their findings with sexually transmitted infection (STI) testing data from 2 EDs within our health system, located in an urban, Ending the HIV Epidemic (EHE) priority jurisdiction [2]. Using EHR data from 2021–2024, we examined the proportion of ED visits with gonorrhea/chlamydia testing who had appropriate HIV co-testing performed; we also expanded our definition to include syphilis co-testing, given the increasing epidemic of syphilis in Los Angeles [3,4]. Fewer than 12% of patients tested for gonorrhea/chlamydia received HIV and syphilis co-testing, suggesting substantial missed opportunities for diagnosis and linkage to care for both HIV and syphilis (Table 1). When HIV co-testing was analyzed separately, approximately 18% of patients received co-testing, which is similar to the preintervention proportions reported by Seibert et al [1,2]