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Pediatrics. 2011 Feb;127(2):e336-44. doi: 10.1542/peds.2010-0967. Epub 2011 Jan 24.

Chlamydia screening among young women: individual- and provider-level differences in testing.

Author information

1
Divisions of Children's Health Services Research and dAdolescent Medicine, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, Indiana 46202, USA. swiehe@iupui.edu

Abstract

OBJECTIVE:

We assessed differences in chlamydia screening rates according to race/ethnicity, insurance status, age, and previous sexually transmitted infection (STI) or pregnancy.

METHODS:

A retrospective cohort study was performed using electronic medical record and billing data for women 14 to 25 years of age in 2002-2007, assessing differences in the odds of a chlamydia test being performed at that visit.

RESULTS:

Adjusted odds of a chlamydia test being performed were lower among women 14 to 15 years of age (odds ratio: 0.83 [95% confidence interval: 0.70-1.00]) and 20 to 25 years of age (20-21 years, odds ratio: 0.78 [95% confidence interval: 0.70-0.89]; 22-23 years, odds ratio: 0.76 [95% confidence interval: 0.67-0.87]; 24-25 years, odds ratio: 0.64 [95% confidence interval: 0.57-0.73]), compared with women 18 to 19 years of age. Black women had 3 times increased odds (odds ratio: 2.96 [95% confidence interval: 2.66-3.28]) and Hispanic women nearly 13 times increased odds (odds ratio: 12.89 [95% confidence interval: 10.85-15.30]) of testing, compared with white women. Women with public (odds ratio: 1.74 [95% confidence interval: 1.58-1.91]) and public pending (odds ratio: 6.85 [95% confidence interval: 5.13-9.15]) insurance had increased odds of testing, compared with women with private insurance. After first STI diagnosis, differences according to race/ethnicity persisted but were smaller; after first pregnancy, differences persisted.

CONCLUSIONS:

Despite recommendations to screen all sexually active young women for chlamydia, providers screened women differently according to age, race/ethnicity, and insurance status, although differences were reduced after first STI or pregnancy.

PMID:
21262889
PMCID:
PMC3025420
DOI:
10.1542/peds.2010-0967
[Indexed for MEDLINE]
Free PMC Article

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