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Trends in the Use of Sexually Transmitted Disease Diagnostic Technologies in California, 1996–2003

Ahrens, Katherine MPH*; Bradbury, K Jayne MPH*; Bauer, Heidi M. MD, MPH*; Samuel, Michael C. DRPH*; Gould, Gail*; Donatoni, Giannina PhD; Higgins, Chandra MPH; Kerndt, Peter MD, MPH; Bolan, Gail MD, MPH*

Sexually Transmitted Diseases: July 2007 - Volume 34 - Issue 7 - p 513-518
doi: 10.1097/01.olq.0000253346.41123.7c

Objective: To describe trends in STD diagnostic test volume and test technology in California from 1996 to 2003.

Study: A self-administered survey was mailed annually to licensed clinical laboratories in California that performed STD testing. Data were collected on volume and diagnostic test type for chlamydia, gonorrhea, syphilis, chancroid, HIV, hepatitis B, herpes simplex virus (HSV), and human papilloma virus (HPV). Data were analyzed for trends over time.

Results: Response rates ranged from 77% to 99% per survey year. The total number of chlamydia, gonorrhea, and syphilis tests increased from 8.1 to 9.3 million annually. The proportion of chlamydia and gonorrhea tests performed using nucleic acid amplification testing increased from 5% to 66% and from 1% to 59%, respectively. Gonorrhea culture testing decreased from 42% to 10% of all gonorrhea tests. HIV test volume increased from 2.4 to 3.1 million tests. Newer technology tests for HSV and HPV were less common but increased in use. Nonpublic health laboratories conducted over 90% of all STD testing.

Conclusions: Analyzing trends in diagnostic technologies enhances our understanding of the epidemiology of STDs and monitoring laboratory capacity and practices facilitates implementation of STD control activities.

This survey of laboratories in California demonstrated increased chlamydia, gonorrhea, HIV, herpes simplex virus, and human papillomavirus testing and increased use of nucleic acid amplification tests (NAATs) for chlamydia and gonorrhea testing.

From the *California Department of Health Services STD Control Branch; and †Los Angeles Department of Health Services STD Control Program

The authors are indebted to the California laboratory directors who have participated in the California Annual Clinical Laboratory Survey. The authors also thank the following staff from California Department of Health Services STD Control Branch: Berlene Osafo-Mensah and Denise Gilson for data entry and management, Abby Sokoloff and Mi-Suk Kang for report generation, the Disease Investigation Area Managers for follow-up activities, Jessica Frasure for editing and formatting, and Roger Tulloch and Jean Montes for survey instrument development. We also thank the following staff from Los Angeles STD Control Program: Clarice Gillis for managing data collection and follow-up activities, Irene Dyer for overseeing the survey from 1995 to 2000, and Merril Marty for development of the original questionnaire.

This project was supported in part by the Centers for Disease Control and Prevention (Comprehensive STD Prevention Systems and Infertility Prevention Project Grant H25/CCH904362), the California Department of Health Services, and the Los Angeles STD Control Program.

Correspondence: K. Jayne Bradbury, California Department of Health Services, STD Control Branch, 850 Marina Bay Parkway, Building P, 2nd floor, Richmond, CA 94804. E-mail:

Received for publication August 22, 2006, and accepted October 27, 2006.

© Copyright 2007 American Sexually Transmitted Diseases Association