Wrong women getting screened for chlamydia. (California Data).

DENVER -- The majority of women aged 25 years and younger who should be routinely screened for chlamydia are not being tested in physician's offices or public clinics in California.

At the same time, a significant proportion of screening tests are being performed on women over 25, even though they are at very low risk of harboring the sexually transmitted infection, Dr. Gail Bolan reported at the annual meeting of the Association of Reproductive Health Professionals.

Dr. Bolan, chief of the sexually transmitted disease control branch of the California Department of Health Services, said that providers remain skittish about screening younger patients for a variety of reasons, including parental involvement in adolescent visits, discomfort in discussing sexual issues, and the invasive nature of the least expensive, least accurate screening tests.

The consequences are profound, since chlamydia remains the most commonly reported infectious disease in the United States. In California, more than 100,000 cases were reported last year, 75% of them from the private sector. Chlamydia is the most common preventable cause of infertility and facilitates transmission of HIV.

New, highly accurate, amplification-based urine tests and a single-dose treatment regimen (1 g of azithromycin) should make chiamydia control efforts easier. But screening of adolescents and young women up to age 25, as recommended by the Centers for Disease Control and Prevention, the Health Plan Employer Data and Information Set, and the U.S. Preventive Services Task Force, just is not happening, she said.

A pilot project for the state's Chlamydia Action Coalition determined that just 65% of women aged 15-25 years were screened in a fully reimbursed fee-for-service setting, 27% in ...