Health insurance tied to lower chlamydia risk

NEW YORK (Reuters Health) – Young U.S. adults with health
insurance are less likely than their uninsured counterparts to
have the sexually transmitted disease chlamydia, a national
study shows.

Chlamydia is the most common bacterial STD in the U.S.,
with teenagers and young adults at greatest risk. The infection
frequently causes no symptoms, but in women it can lead to
long-term complications like pelvic inflammation and
infertility.

Because of this, experts recommend that all sexually active
women younger than 25 get yearly screening for chlamydia.

Young people with health insurance, say the authors of the
new study, may be more likely to get regular screening and
treatment with antibiotics, which would also keep them from
spreading the infection. They may also simply be more aware of
chlamydia and how to lower their risk.

Of the more than 9,300 18- to 27-year-olds in the current
study, those who consistently had health insurance during the
past year had a lower prevalence of chlamydia.

Among men, 6.5 percent of those who lacked insurance for
the whole year had chlamydia, versus just over 3 percent of men
who were continuously insured. The corresponding numbers for
women were 7.5 percent and just under 5 percent, according to
the researchers, led by Dr. William M. Geisler of the
University of Alabama at Birmingham.

In general, black, Hispanic and Native American
participants were less likely to be continuously insured, and
they also had higher chlamydia rates than Asian Americans and
whites, the team reports in the journal Sexually Transmitted
Diseases.

But even with race factored in, men without health
insurance still had a higher risk of chlamydia infection. Among
women, the link between insurance and higher chlamydia risk was
weakened when racial disparities were considered.

For both men and women, chlamydia rates were lower among
those who usually went to a primary care doctor for care,
rather than a hospital emergency room, clinic or other site —
a decision that’s often driven by whether a person has health
insurance.

According to Geisler’s team, the findings suggest that
greater health coverage among young U.S. adults would help
lower their chlamydia rates, through better access to
screening, treatment and counseling on risk reduction.

Of the young adults in their study, 20 percent went without
health insurance for the entire year, while another 20 percent
lacked coverage for some portion of the year.

SOURCE: Sexually Transmitted Diseases, June 2006.