Tuesday, February 1, 2011

Are young minority women screened for Chlamydia at a higher rate than young white women? #disparitiesmatter

Lots of people, who have recently read a study done by the Regenstrief Institute at the Indiana University School of Medicine, agree that young minority women are tested for Chlamydia more often than young white women. The purpose of this post is to begin to highlight the questions that follow this statement of STD testing disparity.

How much more likely are African-American and Hispanic women to be tested for Chlamydia then white women?
"Despite a recommendation from the U.S. Preventive Services Task Force to annually screen all sexually active young women for this disease, only about half of sexually active women, ages 14 to 25, who receive health care, are screened appropriately. The IU and Regenstrief researchers found that black young women were 2.7 times more likely and Hispanic young women 9.7 times more likely to be screened for chlamydia, compared with white young women."
(According to http://www.sciencedaily.com/releases/2011/01/110124111148.htm)

When asked if young minority women are screened for Chlamydia at a higher rate than young white women? Most providers said "Yes." When asked, "Why?", some providers thought that judgments are made about a woman's likelihood of infection based on her race or ethnicity and some did not. Those that did not think judgments are made based on race or ethnicity cited statistical probability as a possible motivation for (seemingly) biased Chlamydia screening, which seemed like circular reasoning to their opposition...

Does type of insurance factor into screening probability?
In addition to race or ethnicity, the researchers found screening likelihood varied by insurance status and also by age. Women with public insurance had greater odds of chlamydia testing, compared with women with private insurance.
(According to http://www.sciencedaily.com/releases/2011/01/110124111148.htm)
Does medical history factor into screening probability?
A medical history of STDs was more important than race or ethnicity or insurance status in terms of differences in chlamydia screening. Young women who had a previous STD were more likely to be screened for chlamydia, no matter their race or ethnicity, and differences by race or ethnicity in testing decreased substantially in this subgroup.
(According to http://www.sciencedaily.com/releases/2011/01/110124111148.htm)
What about pregnancy?
The same was not true for young women who had been pregnant in the past. After a pregnancy, young minority women were much more likely (24 times for Hispanic women and 4 times for black women) to be screened than young white women.
(According to http://www.sciencedaily.com/releases/2011/01/110124111148.htm)
What if any impact does this disparate chlamydia screening practice have on the Chlamydia infection rates of minority women?

What do you think?