STI/HIV testing among Medicaid/CHIP-insured enrollees aged 15-60 years who were diagnosed with high risk sexual behaviors with their opposite-sex or same-sex partners.

BACKGROUND There is a lack of information about high risk sexual behaviors (HRSB) related to gender of sex partner and associated STI/HIV testing among Medicaid enrollees. METHODS We used the 2016 CMS Medicaid claims data to identify enrollees aged 15-60 years with HRSB by ICD-10 codes (Z72.51, Z72.52, and Z72.53). Enrollees diagnosed with HRSB were classified into two groups:1) with same-sex partners and 2) with opposite-sex partners. The date when the initial diagnosis for HRSB was documented was used to define as the index date. We assessed chlamydia, gonorrhea, syphilis, and HIV testing on the index date, in the 6-month period before and after the index date (excluded the index date). HIV testing was limited to enrollees without documented HIV infection. RESULTS Of 50 million Medicaid enrollees aged 15-60 years, 1.2% were identified as enrollees with HRSB in 2016. Of those enrollees with HRSB, 2.7% were enrollees with same-sex partners and 0.71% had documented HIV infection. Chlamydia, gonorrhea, syphilis, and HIV testing rates were 82.4%, 81.9%, 33.2%, and 44.3%, respectively, at the index date. The chlamydia testing rate was ≥ 90% among enrollees who resided in the West, compared to 53% to 61% across other regions. HIV testing was more likely among males and among those with same-sex partners. STI/HIV testing was <30% in the 6-month periods before and after the index date. CONCLUSIONS Among Medicaid enrollees with HRSB, STI/HIV testing varied regionally. Many enrollees were not tested for STI/HIV at the index visit in which they were identified as HRSB.