STD Testing at Emergency Contraception Visits, New York City STD Clinics, 2005–2007

Background:
Women having unprotected sex are at increased risk for STDs and unintended pregnancies. The New York City Department of Health and Mental Hygiene's (NYC DOHMH) 10 STD clinics provide free emergency contraception (EC). To expedite access, EC is provided as a stand-alone service.

Objective:
Characterize STD testing at EC-request visits to NYC STD clinics.

Method:
We analyzed data from NYC STD clinics' electronic medical records for EC-request visits during October 2005–April 2007. For these, we measured frequency and results of Chlamydia trachomatis (CT) or Neisseria gonorrhoea (GC) tests and patient age.

Result:
In total, 3,758 women made 4,657 EC-request visits. EC was the only reason for 66% (3,068/4,657) of visits; the remainder had additional reasons for seeking services. CT/GC testing was done at 27% (1,259/4,657) of EC-request visits; 12% (149/1,259) of these had positive test results for CT or GC. CT/GC testing was performed at 4% (135/3,068) of visits where EC was the only reason for visit, with 7% (9/135) positivity. Median age at EC request was 21 (range: 13–49); 77% (3,570/4,657) of EC requests were by women aged 25. Twenty-five percent (900/3,673) of visits by women aged 25 included tests for GC or CT, and 14% (123/900) of these had positive results.

Conclusion:
The majority of women requesting EC at NYC STD clinics come for EC only, but meet the age criteria for recommended CT/GC screening. The high CT/GC rates among tested EC-requesters and their young age indicate a need for routine CT/GC screening among these women.

Implications:
Providing EC in STD clinics attracts women who can benefit from STD screening but might not otherwise present for care. On the basis of these study findings, NYC STD clinics will begin actively offering STD screening to all EC requesters.