Chlamydia Testing Patterns for Females 15 to 24 Years Receiving Care in Title X-Funded Family Planning Centers, 2015

Background: Chlamydia is easily diagnosed and treatable with antibiotics. However, most cases are asymptomatic, and if left untreated, can cause pelvic inflammatory disease and lead to tubal infertility, ectopic pregnancy, and chronic pelvic pain. Although annual screening is recommended for all sexually active women under 25 years (and for older women at risk), many young women do not receive an annual chlamydia test, even when they are symptomatic, make a routine preventive health visit, or receive a reproductive health service (e.g., Pap test or contraception).

Methods: We use 2015 Family Planning Annual Report (FPAR) data to compare age-specific (15–19 vs. 20–24) chlamydia testing rates across grantees. The FPAR is the only source of uniform performance reporting by Title X grantees; annual submission is required. Grantees aggregate and report data for subrecipients and clinics receiving funding through the grant. We restrict the analysis to data for 82 grantees in the 50 U.S. states and District of Columbia.

Results: In 2015, the average chlamydia testing rates for females 15–19 and 20–24 were the same (57%), and for 71% of the grantees, testing rates for 15–19 and 20–24 year olds differed by less than 5 points. However, most grantees reported testing rates for 15–19 (84% of grantees) and 20–24 (74% of grantees) year olds that were below Healthy People goals. There was also wide variation in testing rates across grantees—from 23% to 92% for 15–19 year olds and from 17% to 88% for 20–24 year olds.

Conclusions: Aggregate data suggest that chlamydia testing practices are consistent for younger and older females in the target age group, but that the overall and grantee-level testing rates are below national objectives. Efforts are needed to identify and address suboptimal testing rates overall and across grantees.