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Background: The Patient Protection and Affordable Care Act (ACA) mandates that certain preventive services be covered by health insurance, including chlamydia screening for young women. The objective of this study is to measure the impact of the ACA on chlamydia screening among sexually active young women, 15 to 24 years old, in the United States from 2006 to 2013 and to predict chlamydia screening by sociodemographic characteristics and previous screening and/or diagnosis of sexually transmitted infections (STI).
Methods: Data are from the National Survey of Family Growth’s two most recent waves, 2006 to 2010 and 2011 to 2013. This study is limited to sexually active young women, 15-24 years. Chlamydia screening is self-reported for the past 12 months. Sociodemographic characteristics include age, race/ethnicity, education, marital status, poverty income ratio, residence, current health insurance, and sexual identity. STI screening and diagnosis include ever being tested for HIV, diagnosis with chlamydia or gonorrhea in the past 12 months, and ever being diagnosed with syphilis, herpes, or genital warts. Chi-square tests were conducted to determine associations between chlamydia screening and covariates. A logistic regression model predicted chlamydia screening.
Results: In this sample, chlamydia screening among sexually active young women was 39.7% and significantly associated with age, race/ethnicity, marital status, residence, current health insurance, having ever been tested for HIV, diagnosis with chlamydia or gonorrhea in the past 12 months, having ever been diagnosed with herpes or genital warts. There was not a significant change in screening based on time.
Conclusions: Chlamydia screening among sexually active young women did not increase immediately after implementation of the ACA, 2006-2010 to 2011-2013. Chlamydia screening reported in this sample is lower than the Healthy People 2020 targets. More sexually active young women should be screened for chlamydia, based on national recommendations and low screening rates.