Federal Register - October 7, 2021
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Source: Federal Register
Federal Register / Vol. 86, No. 192 / Thursday, October 7, 2021 / Rules and Regulations treatment, and one percent of which have a high-grade squamous intraepithelial lesion HSIL 20 or higher, indicating the presence of a more severe condition.
Clinical breast exams can identify patients requiring further evaluation of an abnormal finding. Pap tests or pap smear tests can detect precancers and cervical cancer cells and can also be tested for viral infections that can turn
56173
into cervical cancer. At a population level, these screenings save lives by helping patients identify cancer earlier and by preventing other conditions from developing into cancer.
TABLE D7EFFECT OF THE FINAL RULE ON TITLE X-ASSOCIATED CERVICAL AND BREAST CANCER SCREENING ACTIVITIES
Year
2022
Clinical Breast Exams
Referred
Pap Tests
Tests with ASC or higher
Tests with HSIL or higher
Table D8 presents the effect of the proposed rule on Title X-associated testing for STIs among female clients.
These are calculated by adopting estimates that 49 percent of women are
2023
149,269
7,463
129,799
17,304
195
298,538
14,927
259,598
34,609
391
tested for chlamydia, 55 percent for gonorrhea, 19 percent for syphilis, and 28 percent for HIV. Table D9 presents the same information for men. The share of male clients tested for these
2024
2025
298,538
14,927
259,598
34,609
391
298,538
14,927
259,598
34,609
391
2026
298,538
14,927
259,598
34,609
391
infections are the following: 61 percent for chlamydia, 68 percent for gonorrhea, 39 percent for syphilis, and 53 percent for HIV.
TABLE D8ADDITIONAL WOMEN TESTED FOR SEXUALLY TRANSMITTED INFECTIONS UNDER TITLE X
Year
2022
Chlamydia
Gonorrhea
Syphilis
Confidential HIV
2023
318,008
356,948
123,309
181,719
636,016
713,895
246,618
363,438
2024
2025
636,016
713,895
246,618
363,438
636,016
713,895
246,618
363,438
2026
636,016
713,895
246,618
363,438
TABLE D9ADDITIONAL MEN TESTED FOR SEXUALLY TRANSMITTED INFECTIONS UNDER TITLE X
Year
2022
Chlamydia
Gonorrhea
Syphilis
Confidential HIV
Table D10 reports the additional total clients tested for STIs under Title X.
These tests can identify treatable conditions that can cause discomfort, permanent damage to reproductive systems including infertility, and in certain cases, death. The 2019 Title X
Family Planning Annual Report indicates confidential HIV testing identifies a positive case for
2023
53,006
59,089
33,889
46,055
106,013
118,178
67,779
92,109
approximately 0.38 percent of all HIV
tests performed. Under the final rule, testing under Title X is estimated to identify an additional 873 positive cases of HIV in the first year. In subsequent years, this estimate increases to 1,745.
Testing for these STIs can also reduce the likelihood that an individual will spread an infection. In addition to testing, Title X-funded service sites also
2024
2025
106,013
118,178
67,779
92,109
106,013
118,178
67,779
92,109
2026
106,013
118,178
67,779
92,109
provide HIV/AIDS prevention education. Pre-exposure prophylaxis PrEP has emerged as an effective HIV
prevention strategy for individuals who are most at risk, and the inclusion of PrEP in the HIV prevention services provided at Title X sites is becoming an increasingly important method for protecting individuals of all ages from acquiring HIV.
TABLE D10ADDITIONAL CLIENTS TESTED FOR SEXUALLY TRANSMITTED INFECTIONS UNDER TITLE X
Year
2022
lotter on DSK11XQN23PROD with RULES3
Chlamydia
Gonorrhea
Syphilis
Confidential HIV
Positive Test Results
Additional services of the type provided under Title X will likely result
2023
371,014
416,037
157,199
227,774
873
742,029
832,074
314,397
455,547
1,745
in reduced costs to taxpayers in line with a reduction in unintended
2024
2025
742,029
832,074
314,397
455,547
1,745
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pregnancies, pre-term and low birth weight births, STIs, infertility, and
20 HSIL is the abnormal growth of certain cells on the surface of the cervix.
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742,029
832,074
314,397
455,547
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2026
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