Impact of Significant Decreases Over Time in the Proportion of Sexually Active Medicaid Women Who Had Papanicolaou Testing or Were Pregnant on Trends of Overall Chlamydia Testing Rates.

We examined Medicaid claims data during 2004 to 2013. The proportion of sexually active females aged 15 to 25 years who had Papanicolaou testing or were pregnant significantly decreased during 2004 to 2013 (67.0% to 43.9%, P < 0.05), resulting in a slowed increasing trend in overall chlamydia screening rates. Structural-level interventions for improving chlamydia screening are urgently needed.