A Scoping Review of Approaches to Extragenital Chlamydia and Gonorrhea Screening for Adolescents and Young Adults in the United States.
Loren M Dobkin, Barbara L Brush, Erin M Kahle and 2 others
PMID 41077068WHAT IT FOUND
Extragenital chlamydia and gonorrhea screening for adolescents and young adults was rare in routine care, ranging 0% to 74.2%, but near universal in actively recruited research.
Standardized screening processes may help raise uptake.
Key findings
01Nine U.S. studies of adolescents and young adults ages 12 to 24 years met inclusion criteria.
02Extragenital screening uptake was 89.4% to 99.5% in research and 0% to 74.2% in routine care, and higher uptake studies reported 3.3% to 7.5% oropharyngeal and 8.3% to 27.4% rectal positivity.
03A clinic quality improvement intervention that added a sexual history intake form, written specimen protocols, nurse education and training, and insurance coverage reported a more than 700% increase in rectal and oropharyngeal tests, but the contribution of any single component could not be separated.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Nine studies met inclusion criteria, and they sampled different groups such as young MSM, people assigned female at birth, homeless youth, and clinic patients. That makes the findings hard to apply to all U.S. adolescents and young adults. Most studies were cross-sectional. They describe screening and infection patterns at one time. They do not prove that a protocol or training caused a change. The quality improvement study did not compare patient characteristics before and after the intervention or account for other factors that could have increased testing. Patient preference and acceptability were rarely measured.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not read the more than 700% increase as proof that nurse training alone caused it. The intervention also included intake forms, specimen protocols, and insurance coverage, and the study did not compare patient characteristics or account for other factors.