Prodding Doctors Can Boost Chlamydia Screening
Study finds simple measures can get more girls tested
TUESDAY, Dec. 10, 2002 (HealthDayNews) -- Researchers have discovered that simply encouraging doctors to screen teenage girls for chlamydia can significantly boost testing for the nation's most common sexually transmitted disease.
Kaiser Permanente health plan's Northern California region widened its chlamydia screening program and found that 8 percent of sexually active girls tested were infected with the disease.
"That's incredible. These kids would not have been picked up otherwise," said Dr. Charles Wibbelsman, director of Kaiser Permanente's Teen Clinic in San Francisco.
Chlamydia, which infects both men and women, is more common in the United States than HIV, herpes, syphilis, or gonorrhea. The disease is easily spread among teenagers because they often don't engage in safe sex practices, Wibbelsman said. "A lot of kids who are having vaginal intercourse are not using condoms, and while they may not be getting pregnant, they're taking the risks of getting chlamydia," he said.
The disease has a fairly low profile because it often has no symptoms. Even so, chlamydia can wreak havoc. "The severity is in the young women," Wibbelsman said. "It can cause pelvic inflammatory disease and sterility. It's a real serious problem."
However, it's remarkably easy to cure chlamydia. Just a few doses of an antibiotic will kill off the infection, Wibbelsman said.
Despite the ease of curing chlamydia, only 5 percent of sexually active teenage girls got screened for it during routine checkups or school physicals at Kaiser Permanente facilities in Northern California. As part of their study, officials tried to boost that number by encouraging doctors to screen for the disease and use a basic urine test instead of a complicated and unpleasant gynecological exam.
The result: The rate of chlamydia screening among sexually active girls aged 14 to 18 rose from 5 percent to 65 percent.
The findings appear in tomorrow's issue of the Journal of the American Medical Association.
Part of the challenge has been teaching doctors how to talk to their young patients about sex, Wibbelsman said. "When a kid comes to see you for a (routine) visit, it has to be more than talking about smoking and acne. You need to sit down and talk to these kids alone and get the parents out of the room."
Kaiser Permanente also made the process a little easier by taking urine samples before the doctor-patient chats so they're available for testing if needed, he said.
Dr. M. Kim Oh, a pediatrician at the University of Alabama at Birmingham, agreed that doctors need prodding to realize that their young patients may indeed be sexually active. "A lot of doctors are in denial. How many times have I heard, 'I don't see that kind of patient in my practice?' "
Doctors also have to become comfortable when bringing up the topic of sex with young patients. "Doctors in general are reluctant to initiate the approach," she said. "They basically wait until the patient says, 'I want to be screened.' "
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