Female Visits Research Articles

Structural stigma and sexual orientation disparities in healthcare use: Evidence from Australian Census-linked-administrative data.

This study explores the extent to which structural stigma (which encompasses sociocultural and institutional constraining factors) is associated with sexual orientation disparities in healthcare service and prescription medicine use. Using the responses to the 2017 Australian Marriage Law Postal Survey, we use the regional percentage of votes against legalising same-sex marriage as a measure of structural stigma. We then map these results to Census-linked-administrative data, including 83,519 individuals in same-sex relationships - one of the largest administrative datasets to date where individuals in same-sex relationships are identified. Controlling for regional and individual-level confounders, we find that structural stigma is associated with increased use of nervous system medications (which largely comprise antidepressants) but reduced GP visits for both females and males in same-sex relationships. More regional stigma is also associated with reduced use of pathology services and anti-infective prescriptions for males in same-sex relationships. Altogether, our results suggest that individuals in same-sex relationships living in stigmatised regions are in poorer health but are less likely to access primary healthcare.

Influential Determinants of Patient Satisfaction with Primary Health Care Services from Community Clinics: A Micro Survey in Bangladesh

BackgroundAssessing patient satisfaction with community clinic (CC) services can contribute to promotion of quality of care. This study aimed to investigate the satisfaction level of patients with CC services and to identify the influential determinants of patient satisfaction in a rural area of Bangladesh.MethodsA cross-sectional study using simple random sampling without replacement was carried out in 2019 on 310 patients who have received services from CCs in Haripur upazila, Bangladesh. The patients completed a questionnaire consisting of 17 items on variables related to patient satisfaction. The items were scored using a 5-point Likert scale and patients socioeconomic and demographic characteristics were also recorded. To examine the association of patient satisfaction with other selected determinants, the Chi-square (χ2) test was performed. To assess the net effect of determinants on satisfaction level, multivariate binary logistic regression analysis was conducted.ResultsOverall mean satisfaction level was 3.70±0.982. We found that 68.9% were satisfied and 31.1% were unsatisfied with the services. Moreover, 63.92% of females and 77.48% of males were satisfied. In addition, 70% of individuals aged 15-30 years, 69.28% of those aged 31-45 years and 57.89% of patients aged 46-65+ were satisfied with the services. According to the results of the Chi-square test, gender, occupation, receiving necessary medicine, receiving essential treatments, waiting time, behavior of the CC staffs, hygienic atmosphere, internal environment, female health worker visits, and difficulties faced when taking service from CC were significantly associated with patient satisfaction.ConclusionGiven the important role of patient satisfaction for improving quality of care, it is recommended to cogitate the influential factors when planning for public health promotion.

Display above courts of White‐throated manakins: A new view about its display behavior

AbstractIn order to breed successfully, organisms exhibit multiple strategies to enhance mate attraction, such as elaborate physical ornamentation, behavioral courtship displays, and social interactions, leading to competition or cooperation among potential mates. Within lek mating systems, species evolve under strong sexual selection, which promotes the evolution of exaggerated sexual traits such as male courtship displays. The White‐throated manakin, Corapipo gutturalis, is a small Neotropical bird mating in leks where males display courtships to attract females. Their displays commonly take place on fallen logs on the forest floor, but there are descriptions of displays on higher forest stratum above the typical logs. In this study, we aimed at adding new behavioral information on the above‐log displays and to compare them to log displays in their potential to attract females. For this, we conducted focal observations on seven display courts in two reproductive seasons for 193 hr and recorded above‐log displays in four of the seven observed courts. Above‐log displays were always performed in groups of up to four males from multiple ages and, on only two occasions, these displays ended on the display log. We recorded the same elements previously described during above‐log displays for the species, besides the side‐to‐side slide that had not yet been registered for the species. Above‐log displays included more males than log displays. However, there was no significant difference in the frequency of females visits to above‐log displays or log displays and, likewise, the number of males engaging in the above‐log displays did not determine female visits either. Thus, we found no evidence that above‐log displays are more effective at attracting females than those on the log display. Since above‐log displays are always in the presence of multiple males, we suggest that it may represent male–male competition to define male individuals accessing the display logs.

Burden of Genital Warts in Colombia: An Observational Study

Introduction: Genital warts are benign lesions caused by sexual transmission of human papillomavirus types 6 and 11, with significant impact on healthcare resource use and patients’ quality of life. Objective: To describe the epidemiology of genital warts in adults visiting a physician office for any reason, physician practice patterns, and healthcare resource use and costs in Colombia. Methods: Participants were a convenience sample of 53 physicians in 5 specialties: primary care (15), gynecology (24), urology (12), proctology (1), and dermatology (1). Physicians completed a survey and daily log of all patients 18-60 years old seen over 10 days in their practices in 2016-2017. The physician survey recorded genital warts consultation and management patterns. The daily log recorded patient demographic information and genital warts diagnosis. Results: Among 6,393 patients logged by physicians, the genital warts prevalence was 2.03% (95%CI 1.69–2.38) and incidence 1.30% (95%CI 1.02–1.58). Primary care physicians referred most of their genital warts cases for treatment (female: mean 63.3%, SD=44.8; male: mean 58.3%, SD=43.8). Treatment of non-resistant episodes (<6-month duration) lasted an average of 37.4 days (SD=29.4) and required an average of 4.0 (SD=1.9) office visits for females and 3.0 (SD=1.7) for males. The overall mean cost of an episode of care was USD558.13 (SD=507.30). Conclusion: Genital warts cases reported by most participant physicians were mainly direct-consult, but patients were typically treated by specialists. Much of the genital warts health care utilization and costs reported could be prevented by immunization with the quadrivalent or nonavalent HPV vaccine.

Female Genital Mutilation/Cutting-Pediatric Physician Knowledge, Training, and General Practice Approach.

Female genital mutilation/cutting (FGM/C) is outlawed in much of the world but still mainly occurs from infancy-age 15. Many at-risk and FGM/C-affected girls live in the US. No standard pediatric training exists. A questionnaire assessing FGM/C education, knowledge, diagnostic confidence and external genital examination (EGE) approach was sent to pediatric listservs at 3 hospitals and a child abuse pediatrician (CAP) network. Analysis used χ2 and Fisher's exact tests. Compared to general pediatricians, CAP reported more FGM/C education (RR 2.0 [95% CI 1.3-3.2]), awareness of ICD-9/10 codes (RR 3.2 [95% CI 1.4-7.3]), confidence in identifying sub-types (RR 4.5 [95% CI 2.3-8.7]) and discussing FGM/C (RR 4.2 [95% CI 2.3-7.6]). For 6-12month olds, 10% of general pediatricians reported never performing EGE at female well child visits (WCV), increasing to > 50% for 17-18year olds. Pediatric physicians are not trained to diagnose or manage FGM/C. EGE are not done at WCVs and FGM/C diagnoses are missed.

Medicaid Utilization Before and After a Natural Disaster in the 2016 Baton Rouge–Area Flood

Objectives. To understand changes in behavioral health services utilization and expenditures before and after natural disaster with an adult Medicaid population affected by the Baton Rouge, Louisiana-area flood (August 2016).Methods. We examined de-identified behavioral health claims data for Medicaid-insured adults in the affected region for 10 months before and after flooding (October 2015-June 2017). This constituted 273 233 provider claims for 22 196 individuals. Claims data included patient gender, behavioral health diagnoses, treatment dates, and costs. We made adjustments for Medicaid expansion by using monthly enrollment data.Results. Overall, most male patient behavioral health care visits were for substance use disorders (33.6%) and most female patient behavioral health care visits were for depression-related disorders (30%). Both diagnostic categories increased after the flood by 66% and 44%, respectively. Expansion accounted for a 4% increase in claims. Postflood claims reflected 8% to 10% higher costs.Conclusions. Greater amounts of behavioral health care services were sought in all 10 months of the postflood study period. We observed gender differences in use of services and diagnoses. Behavioral health care services following natural disasters must be extended longer than traditionally expected, with consideration for specific population needs.

Missing female patients: an observational analysis of sex ratio among outpatients in a referral tertiary care public hospital in India

ObjectiveTo investigate gender discrimination in access to healthcare and its relationship with the patient’s age and distance from the healthcare facility.Design and settingAn observational study based on outpatient data from...

Emergency department visits involving opioids in Connecticut, 2011–2015

ABSTRACTBackground: Opioid abuse has demonstrated an unwavering elevation in the past decade. This study examined emergency department (ED) utilization for this growing public health problem in the state of Connecticut.Methods: We evaluated the ED discharges involving opioids in individuals treated in Connecticut EDs from 2011 to 2015. International Classification of Disease, 9th Revision, Clinical Modification and external cause of injury codes were used to identify cases.Results: There were 38,003 ED visits involving opioids during the study period. Visits were most prevalent in males (63.4%) and in those aged 18–44 years (71.8%). The rate of visits (per 10,000 ED visits) in whites (72.7) was more than three times that of blacks (24.7) and nearly double that of individuals of Hispanic ethnicity (37.7). The rate of visits for females under the age of 18 was slightly greater than that for males in the same age groups (2.7 vs. 2.4/10,000 ED visits, respectively).Conclusion: Manual labor work and racial stereotyping are possible causal factors for higher rates of opioid-related ED visits among white males between the ages of 18 and 44, while higher levels of emotional distress may be contributing to similar rates among females under the age of 18 and over the age of 65.

A fixed agreement-consequences of brood size manipulation on alternation in blue tits.

Recent studies have proposed that conditional cooperation may resolve sexual conflict over the amount of care provided by each parent. Such conditional cooperation may allow parents to equalize their investment by alternating their provisioning visits. This alternated pattern of male and female visits, that is, alternation, is thought to stimulate each other’s investment leading to higher levels of provisioning and potential benefits for offspring development. However, experimental studies testing the role of alternation as an adaptive parental strategy to negotiate the level of investment are still absent. Therefore, we manipulated blue tit (Cyanistes caeruleus) parents by temporarily changing their brood sizes to induce changes in demand and thus visit rates. Parents were expected to visit more—assuming that prey sizes were constant—and alternate at higher levels when confronted with an enlarged brood given the greater potential for sexual conflict. In contrast, in reduced broods visit rates and alternation may become lower due to the smaller investment that is needed for reduced broods. We show that the level of alternation did not differ in response to the manipulated brood sizes, despite a directional change in visit rates for enlarged and reduced broods as expected. Nestlings did not benefit from high levels of alternation as no effects on nestling mass gain were present in either of the different manipulations. These findings indicate that alternation does not serve as a mechanism to motivate each other to feed at higher rates. Parents hence appeared to be inflexible in their level of alternation. We therefore suggest that the level of alternation might reflect a fixed agreement about the relative investment by each of the caring parents.

Sex and deception: a rare case of cheating in a lekking tropical bird

Many classic examples of sexually selected traits result from females making informed mate choices. Behaviors by males that increase their own reproductive success at the expense of female choice can undermine such mating systems. We documented an apparently rare example of such a behavior involving “cheating” in a facultatively cooperatively-displaying manakin species (White-ruffed manakin, Corapipo altera). After the cheating event, we observed a dramatic change in the behavior and activity of males displaying at the site and no subsequent female visits. We hypothesize that the infrequency of facultative cooperative behavior may in part result from cheating risks inherent in such systems. A digital video image relating to the article is available at http://www.momo-p.com/showdetail-e.php?movieid=momo190323ca01a.

What can we learn by examining variations in the use of urine culture in the management of acute cystitis? A retrospective cohort study with linked administrative data in British Columbia, Canada, 2005-2011.

IntroductionUrinary tract infections (UTI) are common community-based bacterial infections. Empiric antibiotic recommendations are guided by local resistance rates. Previous research suggests that cultures are overused for uncomplicated cystitis, but practice patterns have not been described in detail. Variations in culturing have implications for the interpretation of antibiotic resistance rates.MethodsWe used a retrospective cohort study to analyze variations in urine culturing among physicians, controlling for patient and physician characteristics. We identified all outpatient physician visits among adults and children for cystitis in British Columbia between 2005 and 2011 using administrative data and linked these to laboratory data on urine cultures. Using hierarchical generalized linear mixed models we explored variations in urine culture submissions for cystitis (ICD code 595) and the associations with patient and physician characteristics, stratified by patient sex.ResultsUrine cultures were associated with 16% of visits for cystitis among females and 9% among males, and 59% of visits overall were associated with antibiotic treatment. Older patients, patients with a recent antibiotic prescription, and long term care residents were significantly less likely to have a culture associated with a cystitis visit, whether male or female. Female physicians and physicians with 16–35 years’ experience were more likely to culture, while international medical graduates were less likely–particularly for female visits. Notably, there was substantial unexplained variation among physicians after controlling for physician characteristics: we found a 24-fold variation in the odds of culturing a female UTI between physicians who were otherwise similar.ConclusionIndividual physicians show substantial variation in their propensity to submit cultures for cystitis visits. Reducing such variation and encouraging appropriate levels of culturing would support effective antibiotic use.

Sources and Factors Related to Oral Health-Care Information Among Dental Patients of a Teaching Hospital in Ibadan, Nigeria.

BackgroundThe World Health Organization has described oral diseases as a global health problem in developing countries and this is mainly attributed to low level of oral health awareness. It, therefore, becomes imperative to investigate how people are informed about oral health care.AimTo determine the sources of oral health-care information and predictors of oral health awareness among individuals seeking dental care at a major tertiary health institution in sub-Saharan Africa.MethodsA cross-sectional study was conducted among patients aged 16 years and older attending the dental outpatients of a major teaching hospital using structured questionnaires. Data obtained were analyzed with SPSS version 23.ResultsA total of 292 patients with a mean age of 38.4 ( SD = 16.3) years participated in the study of which 188 (64.4%) had been educated about oral health prior to the dental consultation. The major source of oral health-care information was dental clinics for 174 (92.6%) participants. The educators or resource persons were mainly dentists 105 (55.9%) and nurses or therapists 67 (35.6%). Females were more likely to have received oral health-care information (odds ratio [ OR] = 1.8, CI [1.1, 3.0], p = .021). Those with previous dental visits were also more likely to have received information about oral health care ( OR = 2.6, CI [1.6, 4.2], p < .001).ConclusionDental clinics and dentists were the major sources of oral health-care information; being female and previous dental visits were significant positive predictors of being a recipient of oral health-care information. Dental public health education through mass and social media should be made a priority to improve access to oral health-care information.

Spatial, temporal and individual‐based differences in nest‐site visits and subsequent reproductive success in wild great tits

The behaviour of individual birds before and during the breeding period may be an important factor determining reproductive success. One commonly observed behaviour during the breeding period in many species is the visitation of multiple potential breeding sites. Much research has attempted to determine the function and consequences of this behaviour, but traditionally studies have been limited to not examining individual‐level behaviour, or only considering a small number of individuals. We used automated recording of RFID‐tagged birds visiting nestboxes to study a population of 80 great tits (Parus major) making > 3500 daily visits across 74 breeding sites, to quantify the frequency, spatial patterning, and temporal occurrence of this behaviour from the pre‐breeding period onwards. We argue that 1) the tight spatial clustering of visits, 2) juveniles visiting more sites than adults, and 3) males (but not females) continuing to visit other sites even as egg laying at their own nest occurs, indicate that territoriality and extra‐pair mating may underpin visitation behaviour. Further, we find that spatial clustering of female visits relates to increased clutch size and fledging success, while frequently visiting a preferred nesting site increases the likelihood of obtaining a breeding site but reduces subsequent reproductive output for both sexes. Our study offers new insight into the mechanisms potentially driving breeding site visitation behaviour, and demonstrates its relationship to individual fitness. We suggest that although visitation behaviour may be related to different components of fitness, future work should use experiments to fully assess the causal factors and effects of visitation behaviour.

The Structure of the Reproductive Gathering of Beluga Whales, Delphinapterus leucas (Pallas, 1776), off Solovetsky Island (White Sea) as Inferred from Results of Photo Identification in 2007–2013

The study of the summer gathering of beluga whales, Delphinapterus leucas, off Cape Beluzhy, Solovetsky Island, White Sea, whose results are considered in the present work, is based on the analysis of photo identification materials over a 7-year period (2007–2013). The Solovetsky gathering is a structural unit of the Onega subpopulation of White Sea beluga whales that consists of individuals with varying degrees of fidelity to this water area. The resident individuals of the Solovetsky gathering usually remain in these waters throughout the summer season, with some of them returning here after each winter, thus, exhibiting philopatry. The non-resident belugas (adult males and females) visit the area only for a certain period of time. During the summer they freely move within the Onega Bay. According to photo identification data, considering the rotation of individuals in the gathering, approximately 195.4 ± 23.5 animals can visit the study area during each summer. This value is significantly greater than the results of visual observations.

Opioid Prescribing and Polypharmacy in Children with Chronic Musculoskeletal Pain.

Thirty percent of adults with fibromyalgia receive an opioid, but the prevalence of opioid prescribing in pediatric chronic musculoskeletal pain is unknown. The aims of this study were to determine the prevalence of and factors associated with opioid exposure and polypharmacy among children with chronic musculoskeletal pain. In this retrospective cohort study using health care claims data from 2000 to 2013, the index date was the first ICD-9 code 729.1. Included subjects were ≥ 2 and < 18 years old at the index date with two or more codes within 12 months and 18 months of continuous enrollment. Subjects with burns, sickle cell disease, or malignancy were excluded. Opioid exposure was defined as one or more prescriptions within six months before or any time after the index date. Polypharmacy was considered minor (2-4 medications) or major (≥5 medications). Of 25,321 included subjects, 20% received an opioid and 26% experienced minor polypharmacy. Opioid exposure was associated with female sex (odds ratio [OR] = 1.27, P < 0.01), Caucasian race (OR = 1.27, P < 0.01), hospitalization (OR = 1.20, P < 0.01), and visit with anesthesiology (OR = 1.97, P < 0.01) or orthopedics (OR = 1.09, P < 0.05). Mental health codes were associated with decreased odds of opioid exposure (all P < 0.05). Children seen by a chiropractor or physiatrist had a reduced odds of receipt of an opioid (OR = 0.42 and 0.84, respectively, both P < 0.01). Twenty percent of children with chronic musculoskeletal pain received an opioid. Twenty-six percent experienced polypharmacy, with the majority receiving 2-4 medications. Increased availability of psychological and nonpharmacologic services are potential strategies to reduce opioid exposure.

Exposure of a diurnal mosquito vector to floral mimics: Foraging responses, feeding patterns, and significance for sugar bait technology

Food location by mosquitoes is mediated by resource-derived olfactory and visual signals. Smell sensation is intermittent and dependent on the environment, whereas visual signals are continual and precede olfactory cues. Success of mosquito bait technology, where olfactory cues are used for attraction, is being impeded by reduced attractiveness. Despite proof that mosquitoes respond to colored objects, including those mimicking floral shape, and that they can discriminate among flowers, the impacts of artificial flowers on foraging remain unexplored. Using artificial flowers with sugar rewards, we examined the foraging responses of Aedes aegypti to various colors in equal choice bioassays. Starved adults were exposed to single flowers with petals of a given color (Single Blue Flowers [SBFs]; Single Red Flowers [SRFs]; Single Yellow Flowers [SYFs]; Single Pink Flowers [SPIFs]; and Single Purple Flowers [SPFs]) and two others with white petals (SWFs). Discrepancies in response time, visitation, feeding, and resting of both sexes were compared between colored flowers and SWFs. Ae. aegypti exhibited shorter response times to colored flowers compared to SWFs, but this behavior was mostly seen for SBFs or SYFs in females, and SRFs, SYFs, SPIFs, or SPFs in males. When provided an option to land on colored flowers and SWFs, female visitation occurred at high rates on SBFs, SRFs, SYFs, SPIFs, and SPFs; for males, this preference for colored flowers was seen to a lesser degree on SBF and SPIFs. Both sexes exhibited preference for colored flowers as sugar sources, but with different patterns: SPIFs, SRFs, SYFs, and SPFs for females; SYFs, SPFs, SPIFs and SRFs for males. Females preferentially rested on colored flowers when in competition with SWFs, but this preference was more pronounced for SPFs, SRFs, and SBFs. Males exhibited an increased preference for SRFs, SPFs, and SYFs as resting sites. Our results indicated the attraction of Ae. aegypti to rewarding artificial flowers, in some cases in ways similar to live flowering plants. The discovery that both male and female Ae. aegypti can feed on nectar mimics held by artificial flowers opens new avenues for improving sugar bait technology and for developing new attract-and-kill devices.

Conspecifics Take Over Black-Backed Woodpecker Nest Following Removal of Resident Pair

On 16 April 2016, a nesting pair of Black-backed Woodpeckers (Picoides arcticus) were illegally killed by a poacher near Rimrock Lake, Washington. We captured the incident on camera and were surprised to observe a female Black-backed Woodpecker visit the partially excavated nest cavity a mere 3 h after the “removal” of the breeding pair (and presumed territory holders). Within 72 h, a male and female were both observed at the abandoned nest and began excavating the partially completed cavity. The intruding pair successfully fledged 2 young from this nest on 10 June 2016. To our knowledge, this is the 1st reported case of a pair of Black-backed Woodpeckers taking over excavation duties at a cavity started by another pair in the same breeding season. While formal studies are needed, this incident suggests conspecific attraction may be used for territory settlement in Black-backed Woodpeckers.

The spatial dynamics of female choice in an exploded lek generate benefits of aggregation for experienced males

The spatial distribution of prospective mates can dramatically affect the process and outcome of mate choice. In a variety of species, spacing between males influences the likelihood that females visit particular individuals or respond to competing signals. Discrimination by females is expected to be highest among neighbouring males, yet males of some species aggregate in ways that apparently facilitate such comparisons. To better understand the selective pressures affecting male aggregation, we investigated how spatial organization of male territories related to female mate sampling tactics and male mating success in the lance-tailed manakin, Chiroxiphia lanceolata. This species displays in a dispersed lek of alpha males, each of which usually has a subordinate beta partner that participates in displays but does not mate with females attracted by their cooperative courtship. We video-recorded courtship activity at display perches of 12 alpha–beta pairs for 42 days in 2013, and documented 478 visits by 82 banded females. We further quantified the relationship of aggregation with genetic mating success for 49 alphas displaying at georeferenced locations in 5 years. Males with close neighbouring alphas were visited by more females, but geographic centrality was unrelated to female visit frequency. Females moved shorter distances between consecutive courtship visits than expected at random, but only 20.5% of 73 females visiting males with video-monitored nearest neighbours visited both neighbouring alpha males. Effects of aggregation on annual genetic reproductive success were only evident after accounting for the stronger effects of alpha age and experience, and only experienced alphas benefited from having close neighbours. Selection for aggregation more likely influences social behaviour of older alphas than settlement decisions by younger males. Benefits of aggregation for experienced alphas mitigate declines in old age, and may generate selective pressure favouring the long-term social alliances that are a key characteristic of this mating system.

Residency and long-distance movements of sevengill sharks (Notorhynchus cepedianus) tagged in San Francisco Bay

BackgroundSevengill sharks are common inhabitants of estuaries and coastal areas and particularly abundant in San Francisco Bay (SFB). There is limited knowledge about the level of residency and migratory movements of this species. We describe the degree of residence of sevengill sharks in SFB and nearby locations, using ultrasonic tags and automated listening stations.ResultsSevengills showed a high degree of residency in SFB, particularly to the Golden Gate (GG) area where they have a strong site preference, both seasonally and inter-annually. Site fidelity was also the highest at the GG. In sharks with deployment times longer than 300 days, we found that > 80% of visits of all mature males were at GG, 80% of visits of a single mature female occurred there, > 85% of visits of most juvenile males, and > 70% of visits of most juvenile females. At GG, sharks moved into the range of the receiver day and night without a strong preference for a particular time of the day, which implies movements up and down the area day and night. At most other locations within the bay, sharks were present during daytime hours, while at Point Reyes during nighttime hours. Sharks moved into SFB during early spring and summer, and moved out of SFB to Point Reyes during late spring and fall. Three sevengill sharks migrated roughly 800 km southeastward along the coastline from SFO, one making three trips back and forth between the sites.ConclusionsThere was strong evidence of residency of sharks within SFB, and sharks repeatedly returned to the same region of the bay with some sharks making long-distance movements.

Extragenital Gonorrhea and Chlamydia Testing Among Women Reporting Extragenital Exposure at an Urban STD Clinic: Is It Worth the Cost?

Background Current guidelines only recommend screening for gonorrhea (GC) and chlamydia (CT) at extragenital sites of exposure in men who have sex with men (MSM). With Medicaid reimbursement for GC/CT nucleic acid amplification testing (NAAT) at approximately $48/test, expanding testing to women requires a value assessment. We report the prevalence of extragenital GC/CT in women with extragenital exposure, determine the proportion of disease missed by urogenital NAAT, and estimate additional cost per infection identified by extragenital testing in women vs MSM.Methods We conducted a retrospective analysis of women undergoing extragenital NAAT for GC and CT at Denver Metro Health Clinic. Data were analyzed for all women with extragenital testing from 9/11/2015 to 7/8/2016, and for MSM from 9/3/2013 to 7/8/2016. Statistical Package for the Social Sciences and Excel programs were used for data analysis.ResultsIn a total 804 female visits, the mean age was 29 (13–67years); 46% were White non-Hispanic; 37% were Hispanic; and 15% were Black. In women, the prevalence of extragenital GC and CT was 2% (16/804) and 5% (38/804), respectively. The rate of GC infection in women was the same at genital and pharyngeal sites (2%, 16/804) but lower at the rectum (0.25%, 2/804). Female chlamydia rates were 11% genital (85/804), 4% pharyngeal (30/804), and 1.4% rectal (11/804). If only urogenital testing had been performed in women, 27% (6/22) of GC infections and 14% (14/99) of CT infections would have been missed. Overall, isolated extragenital infection accounted for 18% (20/111, 95% CI 12–26%) and 65% (943/1453, 95% CI 62–67%) of the combined GC and CT burden in women and MSM, respectively. On average, 40 women and five MSM were screened with extragenital tests to identify one isolated extragenital infection. Estimated additional Medicaid costs for isolated extragenital infection identified in women was $3,851 and in men was $480 for pharyngeal and rectal testing.Conclusion Urogenital screening misses a significant number of extragenital infections in women. However, given the high cost of extragenital screening in women, further work is needed to determine whether screening can be limited to the pharynx or if risk factors can be used to target screening for cost savings.Disclosures All authors: No reported disclosures.