Background:
Although routine Chlamydia trachomatis (CT) screening for sexually-active women aged <=5 years is recommended, little is known about CT screening rates for those women in the general US population.

Objective:
To estimate CT screening using reported STD testing rates for sexually-active women aged 16-25 years by their social-demographic factors and to identify possible interventions to improve CT screening rates.

Method:
We analyzed data from the 2002 National Survey of Family Growth (NSFG). Women were classified as sexually-active if they reported having a male sex partner in the 12 months prior to the interview date. Women were classified as tested if they reported being tested for ‘an STD like gonorrhea, Chlamydia, herpes, or syphilis' by a medical care provider in the last 12 months.

Result:
Of 2542 sampled women aged 16-25 years, 76% were sexually-active. STD testing rates were 42% for sexually-active women and 6% for non-sexually active women. Sexually-active women were more likely to be tested for STDs if they were black (55%) vs. non-black (39%), enrolled in Medicaid (54%) vs. private or no health plan (38%), had two or more sex partners (61%) vs. one (39%), or had pap tests or pelvic exams (53%) vs. no such service (11%). Of sexually-active women, 73% reported they had received pap tests or pelvic exams in the last 12 months.

Conclusion:
Even if all women tested for STDs were screened for CT, only 42% of sexually-active women aged 16-25 years would have been screened for CT whereas screening is recommended for all of these women. CT screening rates could be significantly increased if CT tests were performed when women had pap tests or pelvic exams, because most sexually-active women have routine pap tests or pelvic exams.

Implications:
There is great room for improvement in CT screening for sexually-active women aged 16-25 years in the general US population.