1. Region II IPP Data & Infrastructure Performance Measures Kelly Opdyke, MPH Region II IPP Advisory Committee Mtg May 16-17, 2007 Cicatelli Associates Inc.

2. Region II IPP Workplan, 2006-2007  PRIORITY 2: Incorporate Analysis of Regional Prevalence Monitoring Data for Regional and Local Data-Directed Planning and Quality Assurance GOAL: IPP data will direct the most cost effective implementation of screening and treatment funds. GOAL: IPP data will direct the most cost effective implementation of screening and treatment funds. OBJECTIVE 2B: Identify what percentage of eligible women are being screened on an annual basis among select sites participating in the Region II IPP.OBJECTIVE 2B: Identify what percentage of eligible women are being screened on an annual basis among select sites participating in the Region II IPP.

3. Region II IPP 2005 Screening “Audit” Purpose:  Estimate chlamydia screening coverage among eligible female patients according to Region II IPP minimum screening criteria  Pilot regional methodology for assessing screening coverage and adherence to screening criteria in anticipation of CDC proposed measures of effectiveness

4. Region II IPP Minimum Screening Criteria Title X Family Planning Clinics  All women ≤ 24 years of age attending the clinic for an initial or annual visit will be screened for chlamydia. STD Clinics  All women ≤ 29 years of age attending the STD clinic will be screened for chlamydia.

5. FP Screening Coverage (Expected 85%) Project Area # Sites Sample Size % Screened (95% CI) NJ43864 87.0% (84.8%-89.3%) NYC9170 98.8% (97.2%-100%) NYS741,535 87.9% (86.3%-89.5%) PR38154 47.4% (39.5%-55.3%) TOTAL1642,723 86.0% (84.7%-87.3%)

6. Implications/Discussion  Region II IPP minimum screening criteria for FP include only those women who have an initial or annual (i.e. pelvic) exam  In the past, chlamydia testing required the collection of a cervical specimen.  Highly-sensitive urine-based NAATs (nucleic acid amplification tests) provide an opportunity for expanded screening to additional high-risk clients.

7. Percent of Ct Tests Reported as NAAT Region II IPP, 2004-2006

8. Current Use of Urine Specimen for Ct Testing Among Females Region II IPP, CY2005 Project Area FPSTDAll Other # Tests% Urine# Tests% Urine# Tests% Urine NJ475423.0%63673.0%871611.3% NYC208710.0%207904.0%523793.4% NYS959570.1%103192.5%439914.8% PR70540.0%34202.9%124641.3% USVI9660.0%24513.5%15290.0% Reg II Total1723900.8%411413.4%3234520.7%

9. Current Use of Urine Specimen for Ct Testing Among Females Region II IPP, CY2006 Project Area FPSTDAll Other # Tests% Urine# Tests% Urine# Tests% Urine NJ483874.1%65865.9%920411.4% NYC143880.0%2611026.6%1119757.8% NYS1018800.7%104812.8%378128.6% PR671032.1%498862.1%1318616.1% USVI8000.0%2590.0%11340.0% Reg II Total1721652.8%4842422.1%3850227.9%

10. Region II IPP Strategic Plan 2005-2009  PRIORITY 1: Target/Expand Chlamydia Screening to Young Sexually Active Women and Men at Risk for Infection in Public and Private Settings. GOAL: All at risk men and women under the age of 25 will be screened at least annually. GOAL: All at risk men and women under the age of 25 will be screened at least annually. OBJECTIVE 1C: By December 2007, decrease routine CT and GC screening by 50% in women >30 years of age in FP clinics where the prevalence of CT is less than 2%.OBJECTIVE 1C: By December 2007, decrease routine CT and GC screening by 50% in women >30 years of age in FP clinics where the prevalence of CT is less than 2%.

11. Screening Trends in FP Clinics, Region II IPP N (2003) = 46,077 22,691 41,609 4,684 2,030 117,091 N (2004) = 36,825 21,995 26,050 6,503 2,019 93,392 N (2005) = 47,54220,871 95,9577,054 966 172,390 N (2006) =4838714,388101,8806,710 800172,165

12. Chlamydia Positivity Among Females Age 30+ Yrs in FP Clinics Project Area CY2005 # Tests% Pos NJ7,9672.3% NYC6,4561.0% NYS16,3371.0% PR1,4792.2% USVI2426.2% Reg II Total32,4811.4% Project Area CY2006 # Tests% Pos NJ8,0382.4% NYC4,1511.1% NYS17,5551.2% PR1,2001.4% USVI7410.8% Reg II Total31,0181.5%

13. 2007 Regional IPP Infrastructure Performance Measures Measure 1: Screening Coverage in FP Proportion of female Family Planning users screened for chlamydia, by age group Data Source: FPAR Tables 1 & 11Data Source: FPAR Tables 1 & 11 Measure 2: Test Utilization Proportion of chlamydia tests conducted on females, stratified by age group Data Source: IPP Prevalence Monitoring DataData Source: IPP Prevalence Monitoring Data

14. IPP Infrastructure PM 1: Estimated Ct Screening Coverage YEAR Age Group (Years) # Females Screened # Females Eligible Estimated Screening Coverage (%) CY 2005 15-19 51,028 51,028 112,134 112,13445.5% 20-24 67,541 67,541 140,010 140,01048.2% >24 75,895 75,895 190,106 190,10639.9% TOTAL 194,464 194,464 442,250 442,25044.0% CY 2006 15-19 50,614 50,614 110,734 110,73445.7% 20-24 69,288 69,288 140,198 140,19849.4% >24 79,355 79,355 191,509 191,50941.4% TOTAL 199,257 199,257 442,441 442,44145.0%

15. IPP Infrastructure PM 1: Estimated Ct Screening Coverage Proportion of Female Family Planning Users Screened for Chlamydia, by Age Group, 2006 FPAR

16. IPP Infrastructure PM 2: Chlamydia Test Utilization Age Group (Years) CY 2005 CY 2006 # Females Tested % of Females Tested by Age # Females Tested % of Females Tested by Age 15-19 58,660 58,66023.7% 64,071 64,07124.9% 20-24 88,131 88,13135.7% 91,209 91,20935.4% 25-29 45,986 45,98618.6% 47,087 47,08718.3% >29 54,362 54,36222.0% 55,096 55,09621.4% TOTAL 247,139 247,139100.0% 257,463 257,463100.0%