Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Am J Prev Med. 2010 Sep;39(3):243-50. doi: 10.1016/j.amepre.2010.05.011.
Routine chlamydia screening is a recommended preventive intervention for sexually active women aged </=25 years in the U.S. but rates of regular uptake are not known.
This study aimed to examine rates of annual chlamydia testing and factors associated with repeat testing in a population of U.S. women.
Women aged 15-25 years at any time from January 1, 2002, to December 31, 2006 who were enrolled in 130 commercial health plans were included. Data relating to chlamydia tests were analyzed in 2009. Chlamydia testing rates (per 100 woman-years) by age and rates of repeated annual testing were estimated. Poisson regression was used to examine the effects of age and previous testing on further chlamydia testing within the observation period.
In total, 2,632,365 women were included. The chlamydia testing rate over the whole study period was 13.6 per 100 woman years after adjusting for age-specific sexual activity; 8.5 (95% CI=6.0, 12.3) per 100 woman-years in those aged 15 years; and 17.7 (95% CI=17.1, 18.9) in those aged 25 years. Among women enrolled for the entire 5-year study period, 25.9% had at least one test but only 0.1% had a chlamydia test every year. Women tested more than once and older women were more likely to be tested again in the observation period.
The low rates of regular annual chlamydia testing do not comply with national recommendations and would not be expected to have a major impact on the control of chlamydia infection at the population level.
在美国，对年龄在 25 岁及以下的性活跃女性进行常规衣原体筛查是一种推荐的预防干预措施，但定期接受筛查的比例尚不清楚。
本研究旨在调查美国女性中每年进行衣原体检测的比例以及与重复检测相关的因素。
研究对象为 2002 年 1 月 1 日至 2006 年 12 月 31 日期间任何时候年龄在 15-25 岁之间的、参加了 130 个商业健康计划的女性。于 2009 年分析与衣原体检测相关的数据。根据年龄计算衣原体检测率（每 100 名女性年）和重复年度检测率。采用泊松回归分析观察期内年龄和既往检测对进一步衣原体检测的影响。
共纳入 2632365 名女性。调整特定年龄段的性行为后，整个研究期间的衣原体检测率为每 100 名女性年 13.6 次；15 岁女性为 8.5（95%可信区间：6.0，12.3）次/100 名女性年；25 岁女性为 17.7（95%可信区间：17.1，18.9）次。在整个 5 年研究期间入组的女性中，25.9%至少进行过一次检测，但仅有 0.1%的女性每年进行衣原体检测。女性多次检测，年龄较大的女性在观察期内再次检测的可能性更高。
常规年度衣原体检测率较低，不符合国家建议，预计不会对人群水平的衣原体感染控制产生重大影响。
