Chlamydia Screening of Young Women Seeking Pregnancy Tests

1
Chlamydia Screening of Young Women Seeking
Pregnancy Tests or Emergency Contraception

• Beth Butler
• Infertility Prevention Project Coordinator
• PA Department of Health

2
How this Idea Came About

• In 1999, the PA Project Area had a grant from CDC
  to screen young women coming into FP clinics just
  for a pregnancy testupon chlamydia urine
  screening them the positivity in that group was
  found to be about 11 (the positivity in the PA
  Project Area in Family Planning is usually around
  3.5-4.0)
• The PA Project Area has considered being able to
  provide this service for a number of years

3
Where did the funds come from?

• Funds became available by several means
• The screening criteria was reduced to 25 and
  under
• Improved adherence to screening criteria
• Attention to billing to 3rd party insurance as
  applicable

4
The Next Steps

• As a Project Area we convened a meeting and
  became committed to providing urine chlamydia
  screening to women coming into family planning
  clinics for pregnancy testing and emergency
  contraception
• Collaboratively, the group came up with protocols
  for the clinics to follow to screen this
  population that may otherwise have gone untested

5
Patients to be Screened

• Any female who comes into a Family Planning
  Clinic for purposes of Pregnancy Testing or
  Emergency Contraception (EC)
• Patients should not be receiving speculum
  examinations at the time of the visit
• New or episodic patients who do not access
  routine family planning services

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The Project Begins

• The STD Program, FP, and the contract laboratory
  collaborated to make significant changes to the
  computer laboratory requisition system to collect
  the data
• Clinics identify the patients for this project by
  completing the reason for exam as EC or Pregnancy
  Testing
• The project began in the Spring of 2007
• Data in this presentation is very preliminary
• Approximately 25 of the IPP Family Planning
  clinics submitted tests through May 2007

7
Emergency Contraception Data January
through May 2007

• Currently 13 clinics have submitted tests for EC
  patients
• 32 total urine tests have been submitted
• 1 test was positive for chlamydia
• 3.13 positivity

8
Pregnancy Test Data January through May 2007

• Currently 36 clinics have submitted tests for
  pregnancy test patients
• 417 total urine chlamydia tests were submitted
• 26 tests were positive for chlamydia
• 6.2 positivity
• 3 clinics have performed approximately 64 of the
  tests with 88 of the positives
• (23 positives/266 tests) with 8.6
  positivity
• Many of the clinics participating only did 2-10
  tests so far with no positives

9
Pregnancy Test Data By Age January through May
2007

• Youngest tested 12 years/oldest 45 years
• Average Age 22 years
• 25 years and under73 of total tested
• Positivity 7.89 (24/304 tested)
• Above 25 years 27 of total tested
• Positivity 1.76 (2/113)
• 15-19 years 36 of total tested
• Positivity 9.27 (14/151)

10
Pregnancy Test Data By Race January through May
2007

• Tests with documented race
• 399 tests/26 positives
• 6.5 positivity
• For whites
• 223 tests/9 positives
• 4.0 positivity
• For blacks
• 176 tests/17 positives
• 9.6 positivity

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What is anticipated for the future.

• This project will expand as the program gets
  implemented in clinics
• The project will be sustained as clinics continue
  to adhere to screening criteria and funds
  continue to be available