FLASH: Asking Is Key for Chlamydia Screening

Dr. Kristine Carpenter, a Carle family medicine OB-GYN in Mattoon, IL, boasts high numbers when it comes to chlamydia screening rates. While the subject matter is sometimes tricky to approach, there is nothing tricky about her approach at all.

“What’s really interesting is there’s nothing really earth-shattering about it,” Carpenter said. “I ask patients if they want screening.”

She realizes chlamydia is not every patient’s favorite topic and that it’s not always the easiest subject to bring up.

“I think STD screening kind of has a negative connation,” she said. “Some women come in wanting that screening, but if we don’t ask or bring it up, they’re not comfortable bringing it up.”

She suggests trying to take a conversational approach to a sometimes heavy and awkward discussion.

“When they say, ‘No I don’t really need it,’ or ‘I better not need it,’ or whatever it might be, I say, ‘That’s OK, I’ll ask you until you’re 90,’” she said. “They laugh, and it kind of becomes a light-hearted thing.”

She capitalizes on the natural opportunities to ask about chlamydia testing, like when she is putting in an intrauterine device or when a patient is pregnant.

“There’s a much higher rate of pelvic inflammatory disease if you do not check for that before you put in an IUD,” she said. “So if they happen to have chlamydia, when you put an IUD in, it can lead to pelvic inflammatory disease. In my training, I was always taught, before you put an IUD in, you should do that screening.”

The screening is recommended for sexually active women 24 or younger and those older and at an increased risk, and it can be done through a swab or urine test. Carpenter admits that most of the women she sees who aren’t already having a pelvic exam prefer the urine test over the swab.

She realizes the subject can be complex with teen patients who have parents with them, so Carpenter makes sure to always ask for one-on-one time with her patients to go over their rights and talk through topics they may not feel comfortable discussing in front of a parent.

“I think if we bring up the topic, more people would probably be willing to get the screening done,” she said. “I think it’s just asking. Especially in a women’s health exam, you have a lot of opportunity for preventive care, and this is just one aspect of that.”

Key Takeaways

• Be persistent. Ask patients if they would like you to screen for chlamydia, even if they’ve turned you down in the past.
• List the options. Patients who aren’t already having a pelvic exam might prefer the urine test over the swab.
• Explain the guidelines. Sometimes hearing recommendations helps persuade patients.

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