Tuesday, March 13, 2012
Hyatt Exhibit Hall
Background:CDC recommends annual chlamydia (CT) screening for sexually active females aged <26 years. Community health centers (CHCs) have been a focal point for health care reform, however little is known about CT prevalence among CHC clients.
Objectives:To compare CT/GC positivity rates for non-pregnant females aged 15-25 years tested in CHCs with those tested in family planning (FP) clinics in the same counties.
Methods:Based on CY2010 Region II IPP prevalence monitoring data, 3,117 CT and 4,038 GC tests were associated with 20 CHCs in 12 counties in New Jersey, New York, and the US Virgin Islands; 32 FP clinics in the same counties reported 31,610 CT and 22,576 GC tests.
Results:CT positivity among females aged 15-19 and 20-25 years, respectively, was 11.9% (n=663) and 5.7% (n=2,454) in CHCs, compared with 10.9% (n=9,843) and 6.0% (n=21,767) in FP clinics; GC positivity in CHCs for the same age groups was 1.1% (n=877) and 0.3% (n=3,161), respectively, compared with 1.9% (n=6,913) and 0.9% (n=15,663) in FP clinics. Over 99% of CT tests in CHCs were performed using highly sensitive nucleic acid amplification tests (NAATs), versus 87% of tests performed in FP (up from 55% in CY2009). Among CHCs, the number of GC tests reported in these 12 counties increased by 40% from CY2009 to CY2010 and exceeded the number of CT tests reported.
Conclusions:The burden of CT among females aged 15-25 years attending CHCs is comparable to that observed in FP clinics, and highest among teens; rates for GC were slightly higher in FP clinics than in CHCs.
Implications for Programs, Policy, and Research:As safety-net providers, CHCs may play an increasingly integral role in providing screening to the most at risk populations. Health departments should consider opportunities to partner with CHCs in high morbidity areas to ensure access to screening and expand prevalence monitoring efforts.