Chlamydia Testing of Pregnancy-Test-Seeking Clients in Family Planning Clinics in Washington State

Background: Women attending family planning (FP) clinics for pregnancy testing may be at increased risk for sexually transmitted infections. Emphasis for Chlamydia screening has been on preventive health examinations. Changes in FP program guidelines and laboratory technology make it feasible to conduct Chlamydia screening at brief medical encounters and pregnancy test visits.

Objectives: By the end of this presentation, participants will be able to describe differences in Chlamydia positivity between routine family planning clients and those presenting for pregnancy test (PT) as the primary reason for visit. Participants will be able to identify new opportunities to conduct Chlamydia screening during PT visits.

Methods: FP data were analyzed to determine the percentage of women ages 14-24 who were screened for Chlamydia and received pregnancy tests at the same visit compared with those who did not receive pregnancy tests, 2007-mid-2009. Infertility Prevention Project (IPP) Chlamydia positivity data for pregnant and non-pregnant clients, pregnancy-related and routine visits among women ages 14-24 in FP clinics were analyzed for the same period.

Results: The proportion of women who were screened for Chlamydia without a pregnancy test was 43% (2007), 44% (2008) and 47% (mid-2009). The proportion of women receiving a pregnancy test and Chlamydia test at same visit was 29% (2007), 32% (2008) and 41% (mid-2009). Positivity for pregnant clients was notably higher than for non-pregnant clients in all years analyzed: 7.23% compared to 6.95% in 2008. Positivity for pregnancy-related visits was 6.76% and positivity for routine visits was 5.37% in 2008.

Conclusions: Chlamydia screening and pregnancy testing on the same urine specimen is feasible. Infection rates are higher among PT clients and pregnant clients in Washington FP clinics. PT clients are an important population to screen because of their relatively high rate of chlamydial infection.

Implications for Programs, Policy, and/or Research: Chlamydia screening resources should be directed to include brief and pregnancy test visits.