Self-Reported History of Chlamydia or Gonorrhea Testing Among Heterosexual Women at High Risk of HIV Infection, National HIV Behavioral Surveillance, 2013.

Background: The US Preventive Services Task Force recommends annual chlamydia and gonorrhea screening for sexually active women <25 and ≥25 years old with associated risk factors. We sought to determine self-reported chlamydia and gonorrhea testing and diagnosis rates in the past 12 months in a community-based sample of heterosexual women at high risk of HIV infection.

Methods: We used National HIV Behavioral Surveillance data from 2013 when surveillance was conducted in heterosexual adults with low social economic status. Our analysis was restricted to 18- to 44-year-old women who answered questions regarding chlamydia/gonorrhea testing and diagnosis in the previous 12 months. We calculated the percentage reporting testing and diagnosis. Poisson regressions with generalized estimating equations clustered on recruitment chain were used to assess factors associated with testing and diagnosis.

Results: Among 18- to 24-year-old women (n = 1017), 61.0% self-reported chlamydia testing and 57.6% gonorrhea testing in the past 12 months. Among 25- to 44-year-old women (n = 2322), 49.0% and 47.0% reported chlamydia and gonorrhea testing, respectively. Among the subset of 25- to 44-year-old women who met screening criteria, 51.2% reported chlamydia testing. Having seen a medical provider and HIV testing (past 12 months) were associated with chlamydia/gonorrhea testing in both age groups. Self-reported chlamydia (18-24 years, 21.4%; 25-44 years, 12.2%) and gonorrhea diagnoses (18-24 years, 8.4%; 25-44 years, 6.6%) were common.

Conclusions: A substantial number of eligible women may not have been screened for chlamydia/gonorrhea. Renewed efforts to facilitate screening may prevent sequelae and support disease control activities.