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Human Immunodeficiency Virus, Chlamydia, and Gonorrhea Testing in New York Medicaid–Enrolled Adolescents

Wang, Li, Yan, MBA, MA*; Chang, Man-Huei, MPH*; Burstein, Gale, MD, MPH; Hocevar Adkins, Susan, MD*

Sexually Transmitted Diseases: January 2018 - Volume 45 - Issue 1 - p 14–18
doi: 10.1097/OLQ.0000000000000686
Original Studies

Background Although growing public health efforts have been expended on increasing adolescents' access to human immunodeficiency virus (HIV) and sexually transmitted infection (STI) testing, little is known about the current utilization of those services in clinical settings.

Methods Using 2010 to 2012 New York State Center for Medicare and Medicaid Services Medicaid Analytic eXtract data, we estimated the annual percentage of 13- to 19-year-olds who were tested for HIV, chlamydia (CT), and gonorrhea (GC). A regression analysis was performed to identify factors independently associated with testing utilization. We further examined testing utilization in all adolescent females with 1 or more health care encounter, pregnant females, and adolescents at increased risk for HIV/STI.

Results From 2010 to 2012, HIV, CT, and GC testing rates increased in the overall study population and in most demographic subgroups. Female adolescents, black and Hispanic adolescents, at-risk adolescents, and adolescents with 6 months or longer of enrollment were significantly more likely to be tested. Among adolescent females with 1 or more health care encounter, 19.2% were tested for CT and 16.9% tested for GC in 2012. Among pregnant females, 35.2%, 53.9%, and 46.1% were tested for HIV, CT, and GC, respectively. Among at-risk adolescents, 39.9%, 63.7%, and 54.4% were tested for HIV, CT, and GC, respectively.

Conclusions Although progress had been made by New York State providers to adhere to recommended testing for adolescents, there was a clear gap between the recommended level of testing and the actual level of utilization among sexually active females, pregnant females, and at-risk adolescents. Opportunities exist for community provider and public health collaboration to increase adolescent HIV and STI testing.

A study of human immunodeficiency virus, chlamydia, and gonorrhea testing utilization in New York Medicaid–enrolled adolescents found that many adolescents who accessed health care did not receive testing services even when indicated.

From the *Centers for Disease Control and Prevention, Atlanta, GA; and †Erie County Department of Health, Buffalo, NY

Conflicts of interest and sources of funding: None declared

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official positions of the Centers for Disease Control and Prevention or the Erie County Department of Health.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (

Correspondence: Li Yan Wang, MBA, MA, Division of Adolescent and School Health, NCHHSTP, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail Stop E-75, Atlanta, GA 30329. E-mail:

Received for publication May 4, 2017, and accepted July 11, 2017.

© Copyright 2018 American Sexually Transmitted Diseases Association