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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
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, michael.eberhart@phila.gov
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.