Patient and Clinician Characteristics That Predict the Likelihood of Chlamydia Screening among Women in the US

Background: Chlamydia, the most commonly reported infectious disease in the US, disproportionately affects young women. Guidelines recommend annual screening for sexually active women 25 and younger. Despite yearly increases in chlamydia infections, screening remains lower than recommended.

 Objective: This study utilizes the Eisenberg model of clinician decision-making to determine factors affecting a woman’s likelihood to be screened.

 Methods: A multi-year, cross-sectional study was conducted using the National Ambulatory Medical Care Survey data from 2005-2010. A multivariate logistic regression was performed to determine year differentials and predictors of chlamydia screening.

 Results: A total weighted number of 3,444,621,458 patients were studied. Preliminary results of the regression indicate that race and ethnicity are significant predictors of chlamydia screening. Black women were 2.5 times more likely than white women to be screened (OR=2.54, p<0.001), and Hispanic and/or Latina women were 1.4 times more likely to be screened than non-Hispanic and/or Latina women (OR=1.40, p<0.05). Compared to 2010, patients visiting clinicians in 2007 were 46% less likely to be screened (OR=0.54, p< 0.001), and patients visiting a clinician in 2008 were 38% less likely to be screened (OR=0.62, p< 0.05). Other significant predictors, such as clinician specialty, and relationship between patient and provider, will also be reported.

 Conclusions: Chlamydia screening remains low and disproportionate based on clinician and patient characteristics. Policies aimed at decreasing rates of chlamydia must, in addition to increasing access, attend to lack of policy adherence and the discrepancies in clinician decision-making around whether or not to screen a patient.