Emergency Contraception Visit Seen As Prime Time for STD Screening


CHICAGO — Only 27% of women requesting emergency contraception received screening for chlamydia and gonorrhea, and of those who were screened, 12% were positive for at least one infection, according to the findings of a study conducted in 10 New York City-based sexual health clinics.

“Emergency contraception [EC] visits represent an important opportunity to improve STD testing and treatment. … Screening more women who request emergency contraception should be a high priority,” said the study's lead investigator, Shoshanna Handel, a public health official with the Centers for Disease Control and Prevention and the New York City Department of Health and Mental Hygiene.

Clinic visit data from a 19-month period were analyzed. A total of 3,758 women made 4,657 requests for EC. For 66% of these women, EC was the main reason for the visit, Ms. Handel said at a conference on STD prevention sponsored by the CDC.

The patients' median age was 21 years, but 12% of the requests came from women under 18 years, who are unable to buy EC without a prescription. More than 75% of the requests came from women aged 25 years and under, precisely the group for which the CDC recommends annual chlamydia and gonorrhea screening. Overall, 27% of the EC visits included testing; 11% of these patients tested positive for chlamydia and 2% for gonorrhea. Women aged 25 and younger were significantly more likely to test positive (14% vs. 7%).

When the visits were separated into EC-only requests and visits comprising EC and other services, there was a significant difference in how often screening was offered. “At the EC-only visits, 4% of women were screened. But at the EC-plus visits, 71% were screened,” Ms. Handel said.

After reviewing the analysis, the New York City STD clinics changed their screening policy for women seeking EC. “Our previous protocol stressed expedited EC access. Now we offer chlamydia and gonorrhea screening as a package with emergency contraception,” she said.

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