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Comprehensive Guide: CT/GC Screening & Considerations

Learn about CDC-supported program for chlamydia/gonorrhea screening targeting low-income, sexually active women to prevent infertility. Understand screening criteria, statistics, fiscal impact, and local effects.

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Comprehensive Guide: CT/GC Screening & Considerations

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  1. Appropriate CT/GC Screening & Factors to Consider Becky McCoy MSN, RN, CEN STD Nurse Consultant

  2. Infertility PreventionProject“IPP” • The CDC in collaboration with the Office of Population Affairs of the Department of Health and Human Services supports the program. • Promotes (and funds!) women's reproductive & sexual health via chlamydia/gonorrhea screening & treatment. • Services are intended for low-income, sexually active women attending public clinics (family planning) to prevent infertility.

  3. Who Do We Need To Screen ? Females age 25 and younger: • Does FP clinic have high positivity (> 3%) ? • If so, perform routine CT/GC screening Females age 26 and older: • Do not conduct routine screening • Test if sx are reported or observed • Test if there is a new partner or multiple partners in previous 60 days • Test if exposure to an infected individual

  4. ScreeningStatistics~ WhatDoWeLookAt ?? Essentially divided into 2 groups of data: • Females 25 years and younger • Females 26 years and older

  5. Data ~ 25 and Younger We look at: • Total number tested • Number of “positives” from those tested • Positivity rate Sites identified with low positivity (< 3 %) should cease routine screening & perform targeted screening, i.e. pt complaint of sx, observation of sx, new or multiple partners within previous 60 days or exposure to infected individual

  6. Data ~ 26 and Older We look at: • Total number tested • Number of “positives” from total number tested • Positivity rate Testing should be conducted only if patient is determined to be “at-risk” based on previously indicated criteria, i.e. symptoms, new or multiple partners in previous 60 days or exposure to infected individual

  7. Fiscal Impact STD Program in Frankfort contributes approximately $400,000 annually via CDC-STD grant to support the program, i.e. purchase test kits. Current contract price for each CT/GC test kit is approximately $9.60 per kit. Keep in mind that this is the kit only – does not include labor nor costs at the state lab for actual testing

  8. Local Effect • Decreasing public health dollars • Competing priorities • Recent updates from CDC emphasizing federal goal of avoiding duplication, stating CDC funding should not be used to provide clinical services • Increased emphasis on cost-effective screening, screening rates and timely treatment

  9. Factors to Consider • Are we using test kits / IPP services to process testing for patients with health insurance, Medicaid, etc? • What type of billing systems or process is in place to recover such funds? • What screening tool is in place to assess need for testing prior to collection of specimens ~ use of test kit? • Need for education of all staff regarding significance of appropriate screening & testing

  10. What’s Next? • Be proactive instead of reactive! • Identify as a team what will work best for your individual facilities and implement appropriate interventions.

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