Uptake of regular chlamydia testing by U.S. women: a longitudinal study.
BACKGROUND
Routine chlamydia screening is a recommended preventive intervention for sexually active women aged </=25 years in the U.S. but rates of regular uptake are not known.


OBJECTIVE
This study aimed to examine rates of annual chlamydia testing and factors associated with repeat testing in a population of U.S. women.


METHODS
Women aged 15-25 years at any time from January 1, 2002, to December 31, 2006 who were enrolled in 130 commercial health plans were included. Data relating to chlamydia tests were analyzed in 2009. Chlamydia testing rates (per 100 woman-years) by age and rates of repeated annual testing were estimated. Poisson regression was used to examine the effects of age and previous testing on further chlamydia testing within the observation period.


RESULTS
In total, 2,632,365 women were included. The chlamydia testing rate over the whole study period was 13.6 per 100 woman years after adjusting for age-specific sexual activity; 8.5 (95% CI=6.0, 12.3) per 100 woman-years in those aged 15 years; and 17.7 (95% CI=17.1, 18.9) in those aged 25 years. Among women enrolled for the entire 5-year study period, 25.9% had at least one test but only 0.1% had a chlamydia test every year. Women tested more than once and older women were more likely to be tested again in the observation period.


CONCLUSIONS
The low rates of regular annual chlamydia testing do not comply with national recommendations and would not be expected to have a major impact on the control of chlamydia infection at the population level.
Heijne
Janneke C M
JC
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Tao
Guoyu
G
Kent
Charlotte K
CK
Low
Nicola
N
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008403:Mass Screening / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D012725:Sexual Behavior; D014481:United States / Q000453:epidemiology; D055815:Young Adult