Association of insurance coverage with chlamydia screening.

OBJECTIVES

To examine the rates of self-reported Chlamydia trachomatis (CT) screening among young women and to examine the independent association of type of insurance and specific health plans with these rates.

STUDY DESIGN

Cross-sectional analyses of the 2003 California Health Interview Survey data.

METHODS

Using bivariate analysis and logistic regression models, we assessed the CT screening rate of 1659 sexually active women age 18-25 years, given various factors including type of health insurance coverage. We further assessed the CT screening rate of the subset of 533 sexually active women age 18-25 years enrolled in a private health plan and reexamined the relationship of various factors with CT screening rates.

RESULTS

Being older, an immigrant, or having 1 sexual partner reduced the likelihood of CT screening, while being a smoker, being single, or having had multiple doctor visits as well as a Pap test or clinical breast exam increased this likelihood. The uninsured had the lowest rate, and public managed care enrollees had the highest rate, of CT screening, but this insurance effect was superseded by other explanatory variables. A few differences in significantly associated factors were identified when private health plans were separately examined.

CONCLUSIONS

The results suggest that self-reported CT screening rates were low, particularly among the uninsured. However, these rates were primarily influenced by CT risk factors rather than insurance coverage. Continued efforts to increase CT screening rates are warranted.