The Adoption of Vaginal CT/GC Kits in the Family Planning and STD Clinics in North Carolina

Background: North Carolina has participated in the CDC’s Infertility Prevention Project (IPP) since 1998, screening for Chlamydia in women only through the Family Planning and STD clinics.  Until 2009, the only method for collection used in women was the endocervical route.  

Objectives: To convert to sole use of the vaginal route for CT/GC screening in women in family planning and STD clinics in the state.

Project Description: Prior to July 2009, the Family Planning and STD clinics only used endocervical collection kits for CT/GC in women, when at that time, the State Laboratory of Public Health piloted a small program using urine based collections kits for women in the family planning clinics only.  Because the preferred sample type is now vaginal swabs, a verification study was performed in November 2010.  Allowing for the depletion of current endocervical kits, the conversion to vaginal kits for screening CT/GC was done on September 1, 2011 in both family planning and STD clinics across the state.

Findings: Challenges: 1) a need for education/training of clinicians and staff in the collection technique, 2) staff training in new forms, and 3) assuage clinicians’ perception that client is not capable of self-collected specimen.  Successes: 1) only one kit to manage the expiration dates, 2) excellent kit to use in women who do not require a pelvic exam (i.e., pregnancy test only, under age 21 and/or no Pap, express clinic STD clients who are asymptomatic). 

Conclusions: The local county support has been excellent and the collaboration between the State Family Planning, STD, and Laboratory staff has been beneficial.

Implications for Programs, Policy, and Research:  The use of the vaginal swab kits for CT/GC collection in women is easy to use by the clinician, client and laboratory staff and ensures all women access to this important reproductive health screening.