Screening for Sexually Transmitted Infections After Cervical Cancer Screening Guideline and Medicaid Policy Changes
A Population-based Analysis
Bibliographic Data
| ID | 9104529 |
|---|---|
| Authors | Natasha Parekh (0000-0003-4467-8473, Division of General Internal Medicine, corresponding author), Julie M Donohue (0000-0003-2418-6017, University of Pittsburgh), Jennifer Corbelli (Division of General Internal Medicine, corresponding author), Aiju Men (University of Pittsburgh), David Kelley (0000-0003-0325-3962, Pennsylvania Department of Human Services), Marian Jarlenski (0000-0001-6907-5447, University of Pittsburgh) |
| Year | 2018 |
| Volume | 56 |
| Issue | 7 |
| Pages | 561-568 |
| Publication date | 2018-07-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000925 |
| PMID | 29781922 |
| OpenAlex | W2924693034 |
| Language | EN |
| Citations received | 1 |
| References cited | 23 |
BACKGROUND: Sexually transmitted infection (STI) screening prevents complications and is cost-effective. Annual screening is recommended in sexually active women below 25 years and older women at increased risk. Cervical cancer (CC) screening guideline changes in 2009 and 2012 recommended less frequent screening, causing concern that STI screening would decrease. Pennsylvania Medicaid implemented a family planning program in 2007 which covered women's health services (including STI testing) for uninsured women. It is unclear how STI screening was affected by these countervailing forces. OBJECTIVE: The main objective of this study was to assess STI screening before and after CC screening guideline changes and family planning program implementation, and to determine factors associated with STI screening. RESEARCH DESIGN: This study was an observational cross-sectional study of Pennsylvania Medicaid administrative claims from 2007 to 2013. SUBJECTS: Sixteen-year-old to 30-year-old women enrolled in Pennsylvania Medicaid. MEASURES: Annual STI screening, defined as receipt of ≥1 STI test in respective 1-year periods. RESULTS: Our population included 1,226,079 women-years for 467,143 women. STI screening increased by 48% between 2007 and 2011, and stabilized by 2013. Odds for STI screening were higher among black compared with white women [adjusted odds ratio (AOR), 2.56; 95% confidence interval (CI), 2.60-3.10]; Hispanic compared with non-Hispanic women (AOR, 1.42; 95% CI, 1.39-1.46); family planning program enrollees (AOR, 1.42; 95% CI, 1.40-1.45); and urban compared with rural residents (AOR, 1.05; 95% CI, 1.03-1.06). CONCLUSIONS: STI screening dramatically increased between 2007 and 2011. Potential reasons are family planning program implementation, increased urine/vaginal testing, and reporting improvements. It is reassuring that STI screening did not decrease despite CC screening guideline changes. Between 2011 and 2013, rates stabilized at 45% among all women and 60% among sexually active women below 25 years, suggesting opportunities for improvement
Confidence interval · Environmental health · Family medicine · Guideline · Gynecology · Health care · Logistic regression · Medicaid · Observational study · Obstetrics · Odds · Odds ratio · Population · Cervical Cancer and HPV Research · Cytomegalovirus and herpesvirus research · Demography · Internal Medicine · Medicine · Reproductive tract infections research
| Unique citing works | 1 |
|---|---|
| Citations per year | 0,17 |
| Citation span | 2020 - 2020 (1) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 1 |