Missed opportunities found in adolescent gonorrhea, chlamydia testing in primary care

BALTIMORE — Primary care physicians are missing opportunities to test for gonorrhea and chlamydia in adolescents who do not present frequently, according to data presented at the Pediatric Academic Societies meeting.

In addition, the researchers concluded that in urban clinic settings, adolescent girls were more likely to be tested for gonorrhea and chlamydia and receive repeat testing over 3 years than adolescent boys.

“Current guidelines for chlamydia and gonorrhea screening recommend testing all sexually active girls; however, they note ‘insufficient evidence’ for screening of sexually active boys,” Alison Riese, MD, of the Alpert Medical School of Brown University, in Providence, Rhode Island, said in an interview. “Instead, they suggest targeted screening for boys in certain settings with high prevalence, such as adolescent and high school clinics, correctional facilities, etc.”

To study the patient characteristics associated with gonorrhea and chlamydia testing, and to determine the differences in the rate of testing between boys and girls, Riese and colleagues retrieved ambulatory visit data from 2011 to 2014 from a large urban clinic in the Northeast. All patients were boys and girls aged 14 to 18 years who had been seen at least once in primary or urgent care.

The researchers evaluated differences in gender, age, race/ethnicity, number of visits and number of tests between patients tested at least once for gonorrhea and chlamydia and patients that were never tested.

According to the Riese, although adolescents who had been tested had more primary or urgent care visits to the clinic, 93% of the untested group had at least one primary care visit. Of the total sample, 47% of girls had been tested for gonorrhea and chlamydia, compared with 30% of boys. In addition, girls were more likely to have multiple tests than boys over the 3-year period. Girls were also tested at a younger age than boys.

“In this current study, we were not able to distinguish between screening and testing, nor did we have individual sexual risk behavior information; however, compared to Rhode Island youth risk data, it is likely that a large number of sexually active adolescent boys are not being screened,” Riese said. “It may be that published guidelines have influenced providers in such a way that we are actually under-testing boys and missing chlamydia and gonorrhea infections in these high-risk populations.” – by Jason Laday

Disclosure: Riese reports no relevant financial disclosures.

Reference:

Riese A, et al. Chlamydia and gonorrhea testing patterns in an urban academic clinic. Presented at: Pediatric Academic Societies meeting; April 30 to May 3, 2016; Baltimore.