Best practices in chlamydia (CT) and gonorrhea (GC) screening in a changing healthcare environment: Lessons from the Infertility Prevention Project (IPP)

Background: IPP provides CT/GC screening and treatment of females at family planning, STD and other clinics nationally. Regional infrastructures facilitate translating research to practice. This overview describes IPP implementation and evaluation results from 5 of the most impactful innovations that improved case detection and cost-effectiveness. 1: Screen teenage women. Teens are at highest-risk for CT, yet fewer than 50% are screened annually at FP clinics. Changing clinical protocols and clinic testing caps increased screening of young women and reduced screening of older women. Targeted adolescent testing can increase case detection by 30%. 2: Self-collected specimens. Vaginal swabs improve clinic efficiency, screening coverage, and diagnostic capability. IPP developed free tools for clinicians and clients to promote vaginal swabs and documented rapid uptake of vaginal swab use. 3: Re-testing. Women should be retested after chlamydial infection due to increased risk of re-infection and sequelae. Evaluation showed Individual- and systems-level interventions are needed to improve patient return rates and provider re-testing practices. 4: Pooling Samples. Labs can combine multiple specimens from clinics with low CT/GC positivity, resulting in cost-savings and processing efficiencies. 5: Expedited Partner Therapy. EPT is when CT/GC-infected patients receive antibiotic medications to give to sex partners. Evaluation documents implementation successes and challenges, including clinical protocol development, and clinician attitudes and practices. Conclusion: With 20+ years' experience and evaluation data, IPP is a resource about best practices in CT/GC screening and treatment. These five innovations are important for those engaged in the field and concerned with efficient, effective program practices.