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Chlamydia: Latinas wake up!


Adam, NIH
 
Isabel M. Estrada Portales
Washington 's Voz
08/12/05

The rate of Latina teenagers with Chlamydia is a crying shame: more than double that of white teens.

Federal guidelines recommend regular screening for all sexually active women under age 25, but Chlamydia testing remains low in public and private clinics -- only about one-quarter of women in commercial health plans in 2001 were appropriately screened, according to a study conducted by Kaiser Permanente, in partnership with the Centers for Disease Control (CDC) of Atlanta, Georgia.

But for Latinas, the issue is even more complex.

“Widespread lack of health insurance is arguably the most urgent health problem facing Latinas today,” says Silvia Henriquez, Executive Director of the National Latina Institute for Reproductive Health (NLIRH). “Latinas do not have access to preventative health care--or even routine gynecological care.”

“For young Latinas it is even more urgent that they access basic gynecological care--additionally it is important they have access to culturally competent and linguistically appropriate sex education and sexual health information,” explains Henriquez.

At nearly 900,000 new infections per year, Chlamydia is the most commonly reported sexually transmitted disease (STD) in the U.S. But while Chlamydia is easily cured with antibiotics, and the screening involves a simple and inexpensive test, it often goes undiagnosed because of its lack of symptoms.

About 40 percent of women with untreated Chlamydia infections develop pelvic inflammatory disease and 20 percent of those become infertile, according to CDC. In addition, individuals with Chlamydia are 3-5 times more likely to acquire HIV if exposed.

The study by Kaiser and CDC, which evaluated almost 75,000 electronic medical records of 15-to 26-year-old female members of Kaiser Permanente of the Mid-Atlantic States from 1998 through 2001, shows that simple steps by health care institutions can increase the number of women tested for and diagnosed with Chlamydia.

This is why Henriquez is an advocate for free and low cost, confidential, culturally and linguistically appropriate information and services to prevent STIs. “Latinas must be aware that unprotected sex can lead not just to pregnancy but to sexually transmitted infections and HIV/AIDS. We also need to support comprehensive sex education in schools.”

“When we thought about changes in how we do this screening at Kaiser Permanente, we decided to keep it straightforward. For instance, the clinical assistants in our OB/GYN department now set out a Chlamydia test along with any Pap test, so it's effortless for our physicians,” states Mark Snyder, M.D, associate medical director of information technology, Kaiser Permanente of the Mid-Atlantic States .

And, these standardized changes led to noticeable change. From 1998 to 2001, for women ages 15-26 years-old, screening rates increased by almost a third.

As a result of increased testing, there was a 10 percent increase in the number of new Chlamydia diagnoses.

“Despite national recommendations encouraging annual Chlamydia screening for young sexually active women, far too many women with Chlamydia go undiagnosed every year,” said Dr. Gale Burstein, the lead CDC researcher on the study. “A relatively simple systems-level change like the one implemented by Kaiser Permanente's OB/GYN department could help protect the reproductive health of women across the country.”

It's estimated that health care costs attributable to Chlamydia and its consequences exceed $3.5 billion per year in the United States ; while cure rates can be achieved at a very low cost from $2 to $8.