(P45) The impact of the COVID19 pandemic on the quarterly numbers of STI tests among Medicaid patients using CMS Medicaid claims data, 2019-2020

Background. During the early months of the COVID-19 pandemic, disruptions for routine medical testing, including testing for sexually transmitted infections (STI), were experienced in the US health care system.

Methods. Using the Centers for Medicare and Medicaid Services (CMS) Medicaid claims dataset, we assessed the impact of the COVID-19 pandemic on the quarterly numbers of chlamydia/gonorrhea tests identified by current procedural terminology (CPT) codes from 2019 through 2020 for US Medicaid beneficiaries aged 15-60 years. We compared quarterly numbers of chlamydia/gonorrhea testing in 2020 to the average quarterly numbers of chlamydia/gonorrhea testing in 2019 (baseline). We further estimated the reduction in the quarterly numbers of chlamydia/gonorrhea testing by patient’s state stay-at-home order status for April 2020, sex, age group, and race/ethnicity.

Results: Immediately following the declaration of a national emergency for COVID-19 (March 13, 2019, which was in the 1^st quarter of 2020), the quarterly number of chlamydia tests steeply decreased in the 2^nd quarter and then rebounded toward the baseline level beginning the 3^rd and 4^th quarter of 2020 (compared to 1.89 million at the baseline): 1.85 million at the 1^st quarter, 1.35 million at the 2^nd quarter, 1.88 million at the 3^rd quarter, and 1.83 million at the 4^th quarter of 2020. In the 2^nd quarter of 2020, the quarterly number of chlamydia tests was reduced by 28.5% overall: 30.3% in states with stay-at-home orders versus 14.9% in states without stay-at-home orders; 35.5% in male versus 27.2% in female; 25.7% in non-Hispanic white versus 28.9% in non-Hispanic black versus 29.4% in Hispanic versus 49.9% in non-Hispanic Asian; 29.1% in patients aged 15-24 years versus 23.8% in patients aged 25-34 years versus 29.0% in patients aged 35-44 years versus 44.1% in patients aged 45-60 years. The pattern of quarterly numbers of gonorrhea tests was similar to that of chlamydia tests.

Conclusion. Chlamydia and gonorrhea testing was associated with state stay-home order status and patient demographics. To limit the impact of future pandemics on STI control, public health officials could develop new interventions such as telehealth that enable care for STIs to be delivered during stay- at-home orders.