Racial and Ethnic Differences in Chlamydia and Gonorrhea Testing Locations Among Medicaid-Insured Youth

Abstract

Purpose: Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) infections are common among 15- to 24-year-olds, with Black and Hispanic youth disproportionately affected. Understanding where youth receive CT/GC testing is necessary to address disparities in CT/GC care. Our objective was to identify if differences exist in CT/GC testing locations by race and ethnicity.

Methods: We used 2019 MarketScan Medicaid data to examine CT/GC testing location by youth race and ethnicity.

Results: There were 418,623 CT/GC tests during the study period. Tests were most frequently ordered at medical offices for all races and ethnicities, although less frequently for Black (37.6%) and Hispanic (37.3%) than for White youth (49.3%). Black youth were frequently tested in emergency departments (19.6%), while Hispanic youth were frequently tested in Federally Qualified Health Centers (19.0%).

Discussion: We found significant racial and ethnic disparities in the location of CT/GC testing among Medicaid-insured-youth; these findings should be used to guide strategies that address inequities in CT/GC care.

Keywords: Adolescents; Chlamydia; Disparities; Gonorrhea; Inequity; STIs; Service Location; Sexual health; Youth.