Differential screening for non-viral sexually transmitted infections by type of vaginitis testing.

Abstract

Data are lacking on adherence to Centers for Disease Control and Prevention testing guidelines among insured US women presenting with vaginal health complaints; thus, we quantified vaginitis testing frequency and assessed the co-testing rate for causes of vaginitis and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). This was a retrospective analysis of de-identified data from a medical database. Information from women, ages 18-50 years, was obtained from the Truven MarketScan Commercial Database (2012-2017) using Current Procedural Technology codes; chi-square testing was applied to determine co-testing differences for CT/NG based on vaginitis test type. Odds ratios were calculated to determine the association with CT/NG screening across vaginitis testing categories. Approximately 48% of 1,359,289 women received a vaginitis diagnosis that involved a laboratory-based test. Of these women only 34% were co-tested for CT/NG. CT/NG co-testing was highest for those with nucleic acid amplification testing for vaginitis and lowest for those with no vaginitis testing Current Procedural Technology code (respectively, 71% vs 23%, P < 0.0001). The vaginitis nucleic acid amplification test, indicated by CPT code, was associated with statistically significant, higher CT/NG testing rates. Molecular diagnostics may support vaginitis testing in settings that have limited opportunities for microscopy and clinical exams and offer greater opportunity to offer comprehensive women's healthcare that includes testing for chlamydia and/or gonorrhea infections.