SURF  |   October 2018
Analysis of Sexually Transmitted Diseases Within the Patient Population at a Student-Run Free Clinic
Author Notes
  • From the Campbell University Jerry M. Wallace School of Osteopathic Medicine in Buies creek, North Carolina. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Amy Hinkelman, PhD, Campbell University-Jerry M. Wallace School of Osteopathic Medicine, PO Box 4280, Buies Creek, NC 27506-4280. Email: hinkelman@campbell.edu
     
Article Information
Medical Education / Preventive Medicine / Professional Issues / Graduate Medical Education
SURF   |   October 2018
Analysis of Sexually Transmitted Diseases Within the Patient Population at a Student-Run Free Clinic
The Journal of the American Osteopathic Association, October 2018, Vol. 118, e86-e91. doi:10.7556/jaoa.2018.150
The Journal of the American Osteopathic Association, October 2018, Vol. 118, e86-e91. doi:10.7556/jaoa.2018.150
Abstract

Context: Uninsured patients living in rural areas of North Carolina have been inordinately affected by the increasing prevalence of sexually transmitted diseases (STDs) in the midst of severe budget cuts to treatment programs and a shortage of rural primary care physicians. The Campbell University Community Care Clinic, a self-funded, student-run clinic, provides free health care to uninsured residents of rural Harnett County. As a relatively new clinic serving a unique population, epidemiologic research is paramount to the clinic's continued efficacy.

Objective: To determine which STDs are present in this patient population and to identify demographic groups at higher risk of contracting STDs.

Methods: This study was a retrospective analysis of patient medical records from March 1, 2015, to March 6, 2018. Records were evaluated to identify STD cases based on diagnostic information, such as primary diagnoses, positive laboratory results, and clinical indicators.

Results: A total of 449 patient records were analyzed, revealing an STD incidence rate of 5.3%, which represents a higher STD frequency than the national average of 2%. Our results identified human papillomavirus infection and gonorrhea as the most frequent STDs (n=7 [29.2%] and n=6 [25%], respectively), followed by chlamydia (n=4 [16.7%]), herpes simplex virus (n=4 [16.7%]), syphilis (n=2 [8.3%]), hepatitis C virus (n=2 [4.2%]), trichomoniasis (n=1 [4.2%]), and HIV (n=1 [4.2%]) infections. Among racial/ethnic groups, Hispanics had a slightly higher relative risk (RR) for STDs by a factor of 1.3 when normalized to the average frequency. Patients aged 26 to 29 and 30 to 39 years had a significantly higher RR for STDs: 2.1 and 2.0, respectively. Furthermore, female patients had an STD frequency 3 times that of male patients.

Conclusion: This study reveals noteworthy health risks in a rural uninsured population, including a higher rate of gonorrhea compared with national rates and a higher RR for STDs in certain demographic groups. These findings form a foundation for improvements in care through earlier STD diagnoses, effective treatment, and enhanced patient education.

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