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Differential Screening for Nonviral Sexually Transmitted Infections by Type of Vaginitis Testing.
Casey N Pinto1, Molly Jung2, Megan Wimmer2
1From the Division of Epidemiology, Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA.
Sexually Transmitted Diseases
|April 19, 2023
Summary
Vaginitis testing using molecular diagnostics significantly increased co-testing for chlamydia and gonorrhea among US women. This approach enhances comprehensive women's healthcare by integrating STI screening with vaginitis diagnosis.
Area of Science:
- Reproductive Health
- Infectious Diseases
- Clinical Diagnostics
Background:
- Limited data exist on adherence to Centers for Disease Control and Prevention (CDC) testing guidelines for vaginitis and sexually transmitted infections (STIs) among insured US women.
- Vaginitis is a common complaint, often co-occurring with infections like Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG).
- Quantifying vaginitis testing frequency and associated STI co-testing rates is crucial for improving women's healthcare.
Purpose of the Study:
- To quantify the frequency of laboratory-based vaginitis testing among insured US women presenting with vaginal health complaints.
- To assess the co-testing rates for CT and NG in conjunction with vaginitis testing.
- To evaluate the association between specific vaginitis testing methods and CT/NG co-testing.
Main Methods:
- Retrospective analysis of deidentified data from the Truven MarketScan Commercial Database (2012-2017).
- Inclusion of women aged 18–50 years with vaginitis diagnoses identified by Current Procedural Terminology (CPT) codes.
- Statistical analysis, including chi-squared tests and odds ratios, to compare CT/NG co-testing rates based on vaginitis test types.
Main Results:
- Approximately 48% of over 1.3 million women received laboratory-based vaginitis testing.
- Only 34% of women tested for vaginitis were co-tested for CT/NG.
- Co-testing for CT/NG was significantly higher (71%) when vaginitis testing involved nucleic acid amplification tests (NAATs) compared to women with no vaginitis testing (23%; P < 0.0001).
Conclusions:
- Vaginitis NAATs, identified by CPT codes, are associated with significantly higher rates of CT/NG co-testing.
- Molecular diagnostic methods for vaginitis can improve STI screening in settings with limited resources for microscopy or clinical examination.
- Integrating molecular vaginitis testing offers a valuable opportunity for comprehensive women's healthcare, including essential screening for chlamydia and gonorrhea.
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