15-24 岁女性在长效可逆避孕措施放置术中的衣原体和淋病筛查。
Chlamydia and Gonorrhea Screening Among Women Aged 15-24 Years Undergoing a Long-Acting Reversible Contraceptive Insertion.
机构信息
Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia.
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia.
出版信息
J Adolesc Health. 2021 Jul;69(1):121-126. doi: 10.1016/j.jadohealth.2020.10.024. Epub 2020 Dec 4.
PURPOSE
This study aimed to evaluate the receipt of chlamydia and gonorrhea screening among women aged 15-24 years undergoing long-acting reversible contraception (LARC) insertion.
METHODS
We used the 2016-2017 MarketScan commercial claims data set to identify sexually active women aged 15-24 years with LARC insertion in 2017 and had ≥12 months of insurance coverage before the date of LARC insertion. Sexual activity (defined by Healthcare Effectiveness Data and Information Set chlamydia testing measure) and LARC insertion, including intrauterine device (IUD) and implant insertion, were identified by applicable International Classification of Disease, Tenth Revision, Healthcare Common Procedure Coding System, and Current Procedural Terminology codes. We evaluated chlamydia and gonorrhea testing performed in the preceding 12 months or at the time of LARC insertion among sexually active women aged 15-24 years.
RESULTS
We identified 37,331sexually active women aged 15-24 years with LARC insertion. Among these women, overall chlamydia testing was more frequent among women initiating an IUD (77.8%) than implant initiators (67.8%), p < .001. A similar pattern was seen for gonorrhea testing (80.0% for IUD users, 71.1% for implant users), p < .001. Among sexually active women without chlamydia and gonorrhea testing within the 12 months before the date of insertion, IUD users were more frequently tested for chlamydia (1,410 [20.9%] vs. 433 [9.2%]; p < .001) and for gonorrhea (1,206 [20.0%] vs. 374 [8.9%]; p < .001) than implant users on the day of LARC insertion.
CONCLUSIONS
Our results showed that approximately one in four sexually active women undergoing LARC insertion had not received recommended chlamydia and gonorrhea screening past year. Health care providers may use LARC-related visits as an opportunity to educate patients about, and to offer, chlamydia and gonorrhea screening if they had not been screened in the past 12 months.
目的
本研究旨在评估在接受长效可逆避孕（LARC）植入的 15-24 岁女性中，衣原体和淋病筛查的接受情况。
方法
我们使用 2016-2017 年 MarketScan 商业索赔数据集，确定在 2017 年接受 LARC 植入且在 LARC 植入日期前有≥12 个月保险覆盖的 15-24 岁有性行为的女性。性行为（通过医疗保健效果数据和信息集衣原体检测措施定义）和 LARC 植入，包括宫内节育器（IUD）和植入物植入，通过适用的国际疾病分类、第十版、医疗保健通用程序编码系统和当前程序术语代码进行识别。我们评估了 15-24 岁有性行为的女性在过去 12 个月或 LARC 植入时进行的衣原体和淋病检测。
结果
我们确定了 37331 名接受 LARC 植入的有性行为的 15-24 岁女性。在这些女性中，总体而言，开始使用 IUD 的女性进行衣原体检测的频率高于开始使用植入物的女性（77.8%比 67.8%，p<0.001）。对于淋病检测也观察到类似的模式（IUD 用户为 80.0%，植入物用户为 71.1%），p<0.001。在没有在插入日期前 12 个月内进行衣原体和淋病检测的有性行为的女性中，IUD 用户更频繁地进行衣原体检测（1410[20.9%]比 433[9.2%]；p<0.001）和淋病检测（1206[20.0%]比 374[8.9%]；p<0.001），而植入物使用者在 LARC 插入当天进行的检测较少。
结论
我们的结果表明，大约四分之一接受 LARC 植入的有性行为的女性在过去一年中未接受推荐的衣原体和淋病筛查。医疗保健提供者可以利用与 LARC 相关的就诊机会，对过去 12 个月内未接受筛查的患者进行衣原体和淋病筛查的教育，并提供相关服务。
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