STD Testing in Outpatient Practices

National guidelines have recommended routine STD screening (chlamydia and gonorrhea) for
sexually active young women under the age of 25. Despite these recommendations, many young
women are not being screened for STDs, with some estimates that less than 50% of women
receiving health care are screened for chlamydia. Untreated STDs can lead to important
sequelae to women's reproductive health including pelvic inflammatory disease, infertility
and ectopic pregnancy. One of the most important barriers to widespread STD screening is
provider failure to recognize an opportunity for STD screening. The goal of this study is to
determine whether offering STD screening (chlamydia and gonorrhea) by a non-physician member
of the medical practice (who receives an automated alert indicating STD screening should be
offered) will be associated with a higher rate of STD screening in young women attending
primary care practices compared to usual care (where a physician offers screening with no
electronic alert). This study will be performed in UPMC-affiliated primary care practices
(Family Practice, Internal Medicine, OB/GYN, Pediatrics). Practices will be assigned to the
intervention or usual care. The intervention will be an auto-task in the electronic medical
record to the non-physician/NP/PA medical staff (medical assistants, LPNs, RNs) to offer
chlamydia and gonorrhea screening via urine or self-collected vaginal sampling, in an opt-out
manner, to eligible women. Practices assigned to the usual care group will not have the
intervention. STD screening rates (# women undergoing STD screening/# eligible women) will be
compared between the to groups (intervention practices and control practices). Results of
this study may be important to guide national STD screening recommendations and will address
critical barriers to widespread STD screening.