Opt-Out Screening
with a Universal Approach

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Choose Opt-out Screening with a Universal Approach to take awkward off the table. When using this preventative strategy with your adolescent and young adult females they will be notified that testing will be performed unless declined, regardless of reported sexual activity.

Many patients have concerns about confidentiality and may not admit to being sexually active. This means that many chlamydia and gonorrhea infections go undiagnosed and untreated.1

Hidden STIs

  • ~1 in 2 new STIs were acquired by people aged 15-24 years old.2
  • 5.6 million new chlamydia and gonorrhea cases are estimated every year in the U.S.3
  • People ages 15-24 make up for 18.6% of the population, but account for 42% of gonorrhea cases and 62% of chlamydia cases.2
  • Patients can go undiagnosed and untreated since more than 84% of chlamydia and gonorrhea infections are asymptomatic.4

Untreated Infections Can Lead to Long-Term Health Issues

30%

As many as 30% of untreated chlamydia infections progress to pelvic inflammatory disease (PID).5

With patients having concerns about confidentiality and not admitting to being sexually active, this means many chlamydia and gonorrhea infections go undiagnosed and untreated.1

45%

A study estimated that 45% of tubal factor infertility cases were caused by chlamydia infections.6

PID can lead to long-term health issues such as infertility and ectopic pregnancy.7

24,000

women become infertile due to undiagnosed STIs.8

Improving Patient Care Through Established Screening Guidelines

Major public health and medical societies are all aligned in their recommendations on screening for chlamydia and gonorrhea.9

CDCCenters for Disease Control and Prevention

All sexually active women younger than 25 years should be tested for chlamydia every year.

ACOGAmerican College of Obstetrics and Gynecology

Screen women 24 years and younger, and older women at increased risk.

AAPAmerican Academy of Pediatrics

Annual chlamydia screening of all sexually experienced females younger than 25 years.

USPSTFU.S. Preventive Services Task Force

Screen for chlamydia in all sexually active women aged 24 years and younger and in women aged 25 years and older who are at increased risk.10

AAFPAmerican Academy of Family Physicians

Screen women 24 years and younger, and older women at increased risk.

Please refer to each health organization’s guidelines for complete recommendations.

Take Awkward Off The Table

Choose a Universal Screening Process
  • All patients aged 15-24 years are eligible for testing unless their records are flagged at check-in as having had a negative test within the past 12 months, or they declined to be tested.11
  • Healthcare providers advise patients, “We are going to test you today.”

Universal Screening: An effective strategy. An inclusive solution

This strategy targets all young women within the high-risk age group covered by USPSTF and CDC guidelines (15-24 years), without regard to their reported sexual activity.11 This approach provides comprehensive benefits to patients, physicians, and healthcare organizations, including:

  • Detecting care opportunities that would otherwise be missed.
  • Decreasing STI prevalence and infertility issues.
  • Reducing total cost of healthcare.
5_Women

Risk-based screening = missed opportunities

  • ONLY 44-55% of sexually active women ages 16-24 are screened annually for chlamydia.12
  • Risk-based screening assumes full patient disclosure about their sexual history.
  • Cases of chlamydia and gonorrhea are often found even among those who report abstinence.11
  • Patients refuse physician-offered screening, due to embarrassment or confidentiality concerns.

Primed to Protect Patients’ Reproductive Health

Introducing a universal screening protocol can help to:

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Decrease STI
prevalence

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Eliminate infertility due to undiagnosed infections

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Reduce total
healthcare cost

In many cases, STI screening is covered by the Affordable Care Act.13
For patients, this may mean:
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No co-pay

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No deductible

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No out-of-pocket cost

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* Calculations and data estimates based on cited references.

1. Leichliter JS. Confidentiality Issues and Use of Sexually Transmitted Disease Services Among Sexually Experienced Persons Aged 15–25 Years — United States, 2013–2015. CDC. MMWR. 2017;66(9):237-241. 2.Kreisel, et al. Sexually Transmitted Infections Among US Women and Men: Prevalence and Incidence Estimates, 2018, Sexually Transmitted Diseases: April 2021-Volume 48-Issue 4-p 208-214 doi: 10.1097/OLQ.0000000000001355 3. CDC. Incidence, Prevalence, and Cost of Sexually Transmitted Infection in the United States. Last reviewed: March 16, 2022. Accessed November 11,2022.https://www.cdc.gov/nchhstp/newsroom/ fact-sheets/std/STI-Incidence-Prevalence-Cost-Factsheet.html 4. Detels R, Green AM, Klausner JD, et al. The incidence and correlates of symptomatic and asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections in selected populations in five countries. Sex Transm Dis. 2011;38(6):503-509. 5. Swain GR, et al. Decision analysis: point-of-care Chlamydia testing vs. laboratory-based methods. Clin Med Res. 2004;2(1):29-35. doi:10.3121/ cmr.2.1.29. 6. Price MJ, et al. How Much Tubal Factor Infertility is Caused by Chlamydia? Estimates Based on Serological Evidence Corrected for Sensitivity and Specificity. Sex Transm Dis. 2012;39(3):608-613. doi:0.1097/OLQ.0b013e3182572475. 11. National Chlamydia Coalition. Chlamydia Screening: Follow the Guidelines. Know the Goals. http://chlamydiacoalition.org/screening/. Accessed September 14, 2021. 7. Pelvic Inflammatory Disease (PID) – CDC Fact Sheet. https://www.cdc.gov/std/pid/stdfact-pid-detailed.htm. Updated January 27, 2017. Accessed September 14, 2021. 8. Centers for Disease Control and Prevention. Sexually Transmitted Infections Among Young Americans. https://www.cdc.gov/std/products/infographics/images/Youth-STI-Infographic_620.jpg Published April 2013. Accessed September 14, 2021. 9. National Chlamydia Coalition. Chlamydia Screening: Follow the Guidelines. Know the Goals.http://chlamydiacoalition.org/screening/. Accessed September 14, 2021 10. US Preventive Services Task Force. Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;326(10):949–956. doi:10.1001/jama.2021.14081 11. Owusu-Edusei K, et al. Cost- Effectiveness of Opt-Out Chlamydia Testing for High-Risk Young Women in the U.S. Am J Prev Med. 2016;51(2):216-24. doi:10.1016/j.amepre.2016.01.007 13. Chlamydia Screening in Women. NCQA. http://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality/2017-table-of-contents/chlamydia-screening. Published July 2016. Accessed September 14, 2021. 12. NCQA. Chlamydia Screening in Women. https://www.ncqa.org/hedis/measures/chlamydia-screening-in-women/. Accessed February 2, 2023 13. CDC. Prevention Through Health Care: Preventive Service Tables. https://www.cdc.gov/nchhstp/preventionthroughhealthcare/preventiveservices/std.htm. Updated May 2, 2018. Accessed February 2, 2023.