All ETDs from UAB

Advisory Committee Chair

Connie Kohler

Advisory Committee Members

Linda Casebeer

Jeroan Allison

Scott Snyder

David Macrina

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Education


Background: Chlamydia prevalence in reproductive-age females is 3-20%. This study aimed to determine if physicians’: • sexual activity prevalence perceptions • Chlamydia prevalence perceptions • Sexual history-taking were associated with mean office screening rates; and if physicians’ perceptions of: • sexual activity • Chlamydia were associated with sexual history-taking. Methods: A national MCO’s physicians participated and were asked about their perceptions of sexual activity and Chlamydia prevalence and their sexual history-taking. Data sources included mean office screening rates, online surveys, and AMA’s masterfile. Results: Only 15% of at-risk females were screened (n = 75). Physicians who estimated lower 18 year-old sexual activity prevalence (≤ 40%) had lower mean office screening rates for 16-25 year-old females at-risk (17%, 11%, p = .07). Post-hoc analyses found iii providers who perceived sexual activity prevalence as low had lower at-risk 16-20 year-old female mean office screening rates (11%, 21%, p = .02) but did not have lower at-risk 21-25 year-old office screening rates (10%, 14%, p = .30). Physicians who perceived low patient Chlamydia prevalence (≤ 2%) had lower at-risk female 16-25 year-old mean screening rates (19%, 12%, p = .00). Post-hoc analyses found providers who perceived low patient Chlamydia prevalence had lower at-risk female 16-20 year-old office screening rates (13%, 24%, p = .02), and had lower at-risk female 21-25 year-old office screening rates (10%, 17%, p = .08). Most physicians (65%) reported regularly taking sexual histories from young patients. Sexual history-taking and office screening rates were not associated. Physicians who perceived lower sexual activity prevalence (≤ 40%) were as likely as those who perceived higher (≥ 41%) prevalence to report regularly taking sexual histories. Physicians who perceived patient Chlamydia prevalence as lower (≤ 2%) were as likely as those who perceived higher (≥ 3%) prevalence to report regularly taking sexual histories. Conclusions: Unrealistic perceptions about patient Chlamydia prevalence persist. This suggests that offices infrequently screening at-risk young females are staffed by physicians who do not perceive 18 year-old females or their patients to be at-risk. Physicians can improve their prevalence perceptions of Chlamydia and sexual activity, sexual history-taking, and Chlamydia screening.

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