WARNING: This post contains discussion of Sexually Transmitted Infections (STI)
Authorities have been reporting an alarming increase in rates of STI during recent years. The infections have disproportionately affected young people, with studies reporting nearly 2/3 of the 68 million cases reported in the US occurring in patients between 14 and 24 years old. Treatment is made more complicated by the fact that up to 84% of women with chlamydia and gonorrhea report no symptoms. Prevention, of course, is key, but diagnosis and management is very challenging.
The CDC recommends screening all sexually active young women annually regardless of symptoms and increasingly secondary payers are expecting such screening to be done. However, one of the great challenges of screening young people is that asking these questions is challenging and the answers can be unreliable. (Yes, it turns out people do not always tell the truth about this stuff. Shocking, right?) As a result, universal screening is becoming the standard. When the prevalence of a problem is this high, it makes sense to just do the test. Especially when it’s a simple urine test.
So, this spring we too are going to begin a universal screening program for our highest risk group, young women over the age of 15. Basically, as we often might for other reasons, we will ask patients to leave a routine urine sample as part of their annual PE. Anyone wishing to opt-out is, of course, welcome to to do so. Samples will be sent to a local commercial lab, typically Quest, and results will be shared confidentially. Screening is universally covered by commercial insurance and Husky, although checking your benefits is always wise. (For the uninsured, pricing has been reported between $40-145.)
Hopefully we can help make a small dent in a very big problem.