Reimbursement hampers chiamydia screening. (Sexual Risk Assessment also a Problem).

QUEBEC CITY -- Official guidelines and study findings play only a small part in motivating doctors to increase screening for chlamydial infection, according to Dr. Kathleen Irwin.

Providers know what they are supposed to be doing, but the systems aren't in place to support whatever practice changes need to be made, she said at the annual meeting of the Infectious Diseases Society for Obstetrics and Gynecology.

In April, the U.S. Preventive Services Task Force updated its chiamydia screening recommendations, stating that all pregnant women and all sexually active women, aged 25 and younger, should be screened. Older women with sexual risk factors, such as multiple partners, also should undergo chiamydia screening, according to Task Force recommendations.

The evidence in favor of screening is compelling. With 3 million new infections each year, chlamydia is the most common bacterial STD, resulting in costs of nearly $2 billion a year. Among those infections that go undetected and untreated, 20%30% will lead to pelvic inflammatory disorder, treatment for which costs $1,200 per case.

Similar updated recommendations from the Centers for Disease Control and Prevention are expected this fall.

Chlamydial screening is one of the most highly effective preventive services, along with cervical cancer and colorectal cancer screening and childhood immunizations, according to a ranking conducted by the Partnership for Prevention. Yet sexual risk assessment remains one area that doctors and patients don't often talk about, noted Dr. Irwin of the division of sexually transmitted diseases at the CDC in Atlanta.

In a survey conducted by the Kaiser Family Foundation, only 15% of young women discussed an STD other than HIV during their ...