The 130th Annual Meeting of APHA

3103.0: Monday, November 11, 2002 - 10:35 AM

Abstract #46966

Chlamydia and Gonorrhea Re-Infection Among Women in Philadelphia, PA

Michael Eberhart, BS, Lenore Asbel, MD, and Martin Goldberg. STD Control Program, Philadelphia Department of Public Health, 500 South Broad Street, 2nd Floor, Philadelphia, PA 19146, 215-685-6783,

Background: Despite prevention efforts, incidence rates of chlamydia and gonorrhea continue to rise among women in Philadelphia. Re-infection analysis may explain the impact of recidivism on morbidity and identify factors associated with risk for re-infection.

Objectives: To estimate the rate and impact of chlamydia and gonorrhea re-infection among women in Philadelphia; and to identify individual-level and structural-level risk factors associated with a woman's increased risk of re-infection.

Methods: Secondary analysis was conducted using a comprehensive database of all reported cases of chlamydia and gonorrhea in the City of Philadelphia from January 1, 1994 through December 31, 2000. Re-infection was defined as a subsequent infection more than 30 days after a prior infection. The resulting sample size was 55,135 women.

Results: Results indicated an overall re-infection rate of 28.8% (15,864/55,135). Re-infections accounted for 26,418 infections, or 32.4% of total morbidity in Philadelphia between 1994 and 2000. The strongest predictor for re-infection was young age (<20 years) at time of first infection (odds ratio [OR]=2.8, 95% confidence interval [CI] 2.7 to 2.9). Those who were dually-diagnosed at first infection were more likely to re-infect (36% v. 28%, p<.001). Women with dual diagnosis were also more likely to re-infect within six months (31% v. 26%, p<.001).

Conclusions: Re-infections have a significant impact on total morbidity in Philadelphia, and young women are at greatest risk for re-infection. These findings highlight potential areas for intervention, including more aggressive testing and treatment of male partners.

Learning Objectives:

Keywords: Chlamydia, Women

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Epidemiology of Non-HIV STDs

The 130th Annual Meeting of APHA