Infrequent chlamydial testing among young adults: financial and regional differences

OBJECTIVES: Chlamydia prevalence varies regionally but is highest in the South, which could be the result of regional differences in testing behavior. We describe the national and regional prevalence of self-reported chlamydial infection (Ct) testing and examine how financial resources might be associated with Ct testing. METHODS: We conducted a cross-sectional analysis of data from 12,334 sexually experienced young adults who participated in wave III of the National Longitudinal Study of Adolescent Health (2001-2002). We estimated the prevalence of Ct testing by region and gender, and calculated prevalence odds ratios for the relationship between income or insurance status and Ct testing. RESULTS: Among women, Ct testing in the past year was low (27.3%; 95% CI, 25.5-29.2) and lowest in the South (24.8%). Compared with publicly insured females, privately insured (OR, 0.72; 95% CI, 0.57-0.92) and uninsured females (OR, 0.63; 95% CI, 0.48-0.88) were less likely to report testing. Young women with low income were more likely to report testing than those with a higher income (OR, 1.36; 95% CI, 1.12-1.66). Men reported similar testing patterns. CONCLUSIONS: The South has the highest chlamydia prevalence and the lowest levels of Ct testing in the United States. Reducing infection prevalence and regional disparities in the burden of this infection requires region-focused funding and innovative strategies to increase testing and treatment programs.