Chlamydia and Gonorrhea Screening Among Women Aged 15-24 Years Undergoing a Long-Acting Reversible Contraceptive Insertion

J Adolesc Health. 2021 Jul;69(1):121-126. doi: 10.1016/j.jadohealth.2020.10.024. Epub 2020 Dec 4.


Purpose: This study aimed to evaluate the receipt of chlamydia and gonorrhea screening among women aged 15-24 years undergoing long-acting reversible contraception (LARC) insertion.

Methods: We used the 2016-2017 MarketScan commercial claims data set to identify sexually active women aged 15-24 years with LARC insertion in 2017 and had ≥12 months of insurance coverage before the date of LARC insertion. Sexual activity (defined by Healthcare Effectiveness Data and Information Set chlamydia testing measure) and LARC insertion, including intrauterine device (IUD) and implant insertion, were identified by applicable International Classification of Disease, Tenth Revision, Healthcare Common Procedure Coding System, and Current Procedural Terminology codes. We evaluated chlamydia and gonorrhea testing performed in the preceding 12 months or at the time of LARC insertion among sexually active women aged 15-24 years.

Results: We identified 37,331sexually active women aged 15-24 years with LARC insertion. Among these women, overall chlamydia testing was more frequent among women initiating an IUD (77.8%) than implant initiators (67.8%), p < .001. A similar pattern was seen for gonorrhea testing (80.0% for IUD users, 71.1% for implant users), p < .001. Among sexually active women without chlamydia and gonorrhea testing within the 12 months before the date of insertion, IUD users were more frequently tested for chlamydia (1,410 [20.9%] vs. 433 [9.2%]; p < .001) and for gonorrhea (1,206 [20.0%] vs. 374 [8.9%]; p < .001) than implant users on the day of LARC insertion.

Conclusions: Our results showed that approximately one in four sexually active women undergoing LARC insertion had not received recommended chlamydia and gonorrhea screening past year. Health care providers may use LARC-related visits as an opportunity to educate patients about, and to offer, chlamydia and gonorrhea screening if they had not been screened in the past 12 months.

Keywords: Chlamydia; Commercially insured; Contraception; Gonorrhea; Implants; Intrauterine device (IUD); Long-acting reversible contraception (LARC); Screening; Sexually active women.

MeSH terms

  • Chlamydia*
  • Contraceptive Agents, Female*
  • Female
  • Gonorrhea* / diagnosis
  • Humans
  • Intrauterine Devices*
  • Long-Acting Reversible Contraception*


  • Contraceptive Agents, Female