Evaluating the effect of Medicaid expansion on access to preventive reproductive care for women in Oregon

Publication date: Available online 12 November 2019Source: Preventive MedicineAuthor(s): Susannah Gibbs, S. Marie Harvey, Linh Bui, Lisa Oakley, Jeff Luck, Jangho YoonAbstractWe evaluated the effect of the Affordable Care Act (ACA) Medicaid expansion on receipt of preventive reproductive services for women in Oregon. First, we compared service receipt among continuing Medicaid enrollees pre- and post-ACA. We then compared receipt among new post-ACA Medicaid enrollees to receipt by continuing enrollees after ACA implementation. Using Medicaid enrollment and claims data, we identified well-woman visits, contraceptive counseling, contraceptive services, sexually transmitted infection (STI) screening, and cervical cancer screening among women ages 15–44 in years when not pregnant. For pre-ACA enrollees, we assessed pre-ACA receipt in 2011–2013 (n = 83,719) and post-ACA receipt in 2014–2016 (n = 103,225). For post-ACA enrollees we similarly assessed post-ACA service receipt (n = 73,945) and compared this to service receipt by pre-ACA enrollees during 2014–2016. We estimated logistic regression models to compare service receipt over time and between enrollment groups. Among pre-ACA enrollees we found lower receipt of all services post-ACA. Adjusted declines ranged from 7.0 percentage points (95% CI: −7.5, −6.4) for cervical cancer screening to 0.4 percentage points [−0.6, −0.2] for STI screening. In 2014–2016, post-A...
Source: Preventive Medicine - Category: International Medicine & Public Health Source Type: research

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Conclusions High levels of high-risk HPV infection and type-specific persistence were documented, heightening the urgency of mass role out of HPV vaccination. The association between HPV persistence and HIV transmission is a novel finding, warranting further study.
Source: Sexually Transmitted Diseases - Category: Sexual Medicine Tags: Original Studies Source Type: research
The objective of this study was to determine the barriers related to the non-acceptance of cervical cancer screening using the Pap smear test in women of childbearing age from a rural Peruvian community. Methods: Cross-sectional study, with a total of 892 women of childbearing age from the rural Peruvian community of Marián, Huaraz province, Ancash region, who did not accept screening for cervical cancer using the Pap smear test during their care at the Marián Health Centre. A questionnaire given from September 2017 to April 2018 was used. The information was processed with the statistics programme for so...
Source: Ecancermedicalscience - Category: Cancer & Oncology Tags: Ecancermedicalscience Source Type: research
UCLA Health Rates of sexually transmitted diseases have risen for the past four years to record highs in the United States, according to the Centers for Disease Control and Prevention ’slatest analysis. In California, the state health departmentfound that the number of people diagnosed with syphilis, gonorrhea or chlamydia in 2017 was 45 percent higher than five years prior.These sorts of statistics may spark a fear that there ’s little we can do to protect ourselves — but that’s not the full story.Dr. Leena Nathan, an obstetrician/gynecologist at UCLA Health-Westlake Village, consults with peo...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
Background Sub-optimal cervical cancer screening in low- and middle-income countries contributes to preventable cervical cancer deaths, particularly among human immunodeficiency virus (HIV)-positive women. We assessed feasibility and outcomes of integrating cervical cancer screening into safer conception services for HIV-affected women. Methods At a safer conception service in Johannesburg, South Africa, HIV-affected women desiring pregnancy received a standard package of care designed to minimize HIV transmission risks while optimizing prepregnancy health. All eligible women were offered Papanicolaou smear, and those...
Source: Sexually Transmitted Diseases - Category: Sexual Medicine Tags: Original Studies Source Type: research
Abstract Young patients and adolescents with chronic rheumatic diseases have the same desires, fears and needs in terms of sexuality and pregnancy as their healthy peers. In most cases adolescents are already sexually active before transition from pediatric to adult rheumatological care takes place. Pregnancies in women with rheumatic diseases are associated with increased maternal and fetal risks, especially when they occur unplanned in the course of active disease or under teratogenic drugs. Safe contraception is therefore crucial in preventing unwanted pregnancies. The choice of contraception should anticipate ...
Source: Zeitschrift fur Rheumatologie - Category: Rheumatology Authors: Tags: Z Rheumatol Source Type: research
Background: Human Papillomavirus (HPV) is the sexually transmitted infection and cause of cervical cancer, with considerable morbidity and mortality worldwide. Objective: We evaluated and summarized the available evidence on the vertical transmission rate of HPV in pregnant women for their newborns, as well as the possible risk factors for vertical transmission of HPV.
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: UMP. 662 Source Type: research
July 23, 2018A simple procedure is lowering the risk for thousands of couples in  Tanzania.Twenty-one-year-old Khadija Butemi was doing her morning chores when she heard an announcement through a loudspeaker passing by on the nearby country road.There was a campaign going on, it said, for men who wanted to undergo voluntary medical male circumcision (VMMC). She immediately thought of her husband, a 22-year-old fisherman, who was down by the lake fishing.The couple lives with their two-year-old daughter in Nansio, a remote village on the island of Ukerewe, Tanzania. VMMC isn ’t routinely offered in the area, and ...
Source: IntraHealth International - Category: International Medicine & Public Health Authors: Source Type: news
Authors: Aslan E, Bechelaghem N Abstract The importance of a healthy vaginal micro-flora is indisputable. Therefore, intravaginal practices, such as vaginal douching (VD), may inhibit or lower the colonisation of beneficial Lactobacilli strains. Although the results of disrupted vaginal microbiota have been widely reported in the literature, direct microbicidal effects of products used for VD have been rarely studied. Moreover, there are certain studies advocating the beneficial effects of VD. This in vitro study was designed to provide more evidence to help health care givers in disseminating the knowledge that VD...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
Acute inflammation of the uterine cervix can lead to serious problems such as pelvic inflammatory disease (PID), endometritis, and complications of pregnancy and childbirth. As intervals for routine gynecologic screening examinations lengthen, cervical infections, especially if asymptomatic, may be missed. Annual wellness examinations and other patient visits outside routine gynecologic cancer screening visits should include brief evaluation with sexual risk assessment and a gynecologic examination if indicated. If cervicitis persists after standard treatment for sexually transmitted infections (STIs), consider Mycoplasma ...
Source: Journal of the American Academy of Physician Assistants - Category: Primary Care Tags: Special Topics in Women's Health Source Type: research
Right at the end of every year I write a letter summarizing my issues and charities. And as I own the joint here, I post it on THCB! Please take a look–Matthew Holt Well 2017 has been quite a year, and last year 2016 I failed to get my end-of-year letter out at all. This I would like to think was due to extreme business but it probably came down to me being totally lazy. On the other hand like many of you I may have just been depressed about the election–2016 was summed up by our cat vomiting on our bed at 11.55 on New Years Eve. Having said that even though most of you will never comment on this letter and I ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Matthew Holt Charity Patient Activism Source Type: blogs
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