UCLA

Background: The Centers for Disease Control and Prevention (CDC) reports that men have recently experienced a rise in rates of sexually transmitted infections (STIs)—particularly chlamydia, gonorrhea, and syphilis. While STI testing has improved in cost, portability, and accuracy, STI notification still relies on telephone calls. Prompt STI notification is critical to reduce the number of days between STI test and STI treatment in order to stop future STI transmissions and prevent long-term health complications. In 2014, AIDS Healthcare Foundation (AHF) began implementing Healthvana, an online patient engagement platform and smartphone application, to notify AHF Wellness Center clients of STI test results. The primary study objective of this dissertation is to determine whether Healthvana reduced the number of days between STI test, notification, and treatment for male clients. The secondary study objective of this dissertation is to better understand the characteristics of clients who opted in to Healthvana.

Methods: STI test, notification, and treatment data as well as risk assessment data from 18 AHF Wellness Centers between January 1, 2014 and December 31, 2015 were retrospectively collected. Male clients were included in the cross-sectional analysis if they were tested, notified, and treated for STIs (n = 1,460). Ordinary least squares and Poisson regressions were utilized to analyze differences in the mean number of days between STI test, notification, and treatment. Logistic regressions were utilized to analyze the difference between clients who did not opt in to Healthvana and clients who opted in to Healthvana.

Results: The mean number of days between STI test and notification was reduced by 22 percent following Healthvana implementation, from nine days to seven days (p < 0.001). Overall, Healthvana implementation reduced the total days between STI test and treatment by two days, from 13 days to 11 days (p = 0.022). Clients under the age of 25 years experienced greater odds of opting in to Healthvana than clients who were 30-39 years old (p = 0.027) and clients who were aged 40 years and older (p = 0.004). Healthvana implementation at AHF Wellness Centers demonstrates a significant reduction in the number of days to STI treatment.