Health insurance tied to lower chlamydia risk

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.