TUESDAY, March 13 (HealthDay News) -- Far too few sexually
active young women are getting tested for chlamydia, an oversight
that could lead them down a perilous path to severe health
consequences, including infertility, later in life.
A new survey from the U.S. Centers for Disease Control and
Prevention found that only 38 percent of sexually active girls and
women were screened for this common sexually transmitted disease
(STD) in the year prior to being questioned. Chlamydia often
infects men and women without causing symptoms.
Not only that, another new study finds that only a small
proportion of men and women got the recommended follow-up test once
they had tested positive for chlamydia. Re-infection with chlamydia
is common if partners remain untreated. In those women who are left
untreated, chronic pelvic pain and ectopic pregnancies can result,
along with infertility.
Both reports were to be presented Tuesday at the National STD
Prevention Conference in Minneapolis, as are two additional studies
outlining ways clinics and providers might improve on these
numbers.
According to Dr. Gail Bolan, director of the CDC's division of
STD prevention, an estimated 2.8 million new cases of chlamydia
occur each year in the United States.
The CDC recommends annual testing for sexually active women aged
25 and under, as well as retesting either three months after
initial treatment for chlamydia or during their next regular health
care visit in the year following treatment, said Bolan, who spoke
at a Tuesday news conference.
With only about one third of young women getting tested for
chlamydia, two-thirds (9 million) are going without, noted study
author Dr. Karen Hoover, a medical epidemiologist with the CDC. She
called the results "alarming."
Slightly more encouraging, she said, was the news that some
groups at particularly high risk for chlamydia infection actually
had higher testing rates. This included black women (55 percent got
tested), those with more than one sexual partner (47 percent) and
people who had no health insurance (41 percent) or relied on
government-subsidized insurance (50 percent).
Women who received some sort of reproductive health care, such
as contraception, a Pap smear for cervical abnormalities or a
pregnancy test were also more likely to get tested compared with
women who received no such care (45 percent vs. 4 percent). Older
women also had higher testing rates.
"This suggests that we may be moving in the right direction," Hoover noted.
The study authors had no data on chlamydia testing in men as
routine testing in this population is not recommended by the CDC,
Hoover said.
"There is insufficient data to support this recommendation," she said, although retesting rates among men "will probably be the subject of future analyses."
A second study, based on a laboratory data from almost 64,000
men and women who had tested positive for chlamydia, found that
only 11 percent of men and 21 percent of women went for their
recommended retest within six months of the original positive
results.
Among those who got a follow-up test, one-quarter of men and 16
percent of women were positive.
"Retesting rates were much lower than we had expected," said study author Kelly Morrison Opdyke, of Cicatelli Associates Inc., a non-profit organization.
Again, though, certain demographic groups were more likely to
get retested, including younger people (under 25), those visiting
family planning clinics (as opposed to STD clinics) and health
centers, including health centers at universities or colleges.
Retesting rates also declined over the study period, which
spanned 2007 through 2009, although Hoover said researchers weren't
able to explain this drop.
Two additional studies found success in boosting re-testing
rates by using relatively simple follow-up and reminder
systems.
One system, which included email and telephone reminders to
students visiting the University of Buffalo's student health center
in New York, managed to boost re-testing rates for chlamydia and
gonorrhea from 17 percent to 86 percent in just one semester.
Chlamydia accounted for most of the infections detected. Here,
retesting rates jumped from 16 percent to 89 percent.
Another study used pop-up screens on electronic medical records
to remind providers that a patient needed to be re-tested. The
system was conceived after researchers noted low re-testing rates,
even among women who visited a health care provider one to six
months after their initial treatment. In this case, testing for
gonorrhea and chlamydia increased from 70 percent to 86
percent.
More information
The U.S. Centers for Disease Control and Prevention has more on
chlamydia.