Chlamydia Among Women Aged 15-24 Years Attending New Mexico Infertility Prevention Project Family Planning Clinics, 1997 – 2007: Changing Trends Over Time

Tuesday, March 11, 2008
Continental Ballroom
Wanicha Buraphacheep-Coggins, MD , New Mexico Department of Health, State of New Mexico, Santa Fe, NM
Lynn Mundt, MBA , New Mexico Department of Health, State of New Mexico, Santa Fe, NM
David Fine, PhD , Center for Health Training, Seattle, WA

Background:
The Region VI Infertility Prevention Project (IPP) funds CT screening and treatment services for women attending New Mexico family planning (FP) clinics.

Objective:
1) Assess CT trends among women aged 15-24 years attending FP clinics, 1997-2007; and 2) identify factors that might influence CT trends. Women age 15-24 were selected because this group is an IPP priority population.

Method:
CT positivity was calculated annually from 80,000 tests among women aged 15-24 years seen at NM FP clinics, 1997 - 2007.

Result:
Annual CT testing volume among FP female clients aged 15-24 years increased from about 8,000 tests/year, 1997-99, to over 9,000/year, 2006-07. Between 1997 and 2007, CT+ among women ages 15-29 increased (6.6% to 8.7%); CT+ also increased for women ages 20-24 (5.0% to 7.4%). Between 2000 and 2003, there were two changes that might have contributed to increasing CT prevalence. 1) The 2001 U.S. Preventive Services Task Force recommended age as the most important CT risk marker; 2) in 2004 NM Scientific Lab Division switched to a nucleic acid amplification test (NAAT).
Since 2004, FP Program has emphasized targeted screening using age (25 and under) as a primary criterion. This shift resulted in an increased proportion of teens tested among FP clients (1997: 32%, 2007:35%). Also, between January 2005 and June 2007, CT+ decreased in women aged 15-19 years (11.4% to 8.7%) and in female clients aged 20-24 years (8.1% to 7.4%).

Conclusion:
Annual NM CT testing volume increased, 1997-2007. Over 11 years, CT+ was stable, until the advent of NAATs when CT+ increased. However, in the past two years CT+ has decreased in IPP's target population.

Implications:
Through IPP states can evaluate CT program impacts, particularly among high-risk women attending public clinics. The trend change remains unexplained. Further analyses should explore changes in client and community characteristics.
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