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Self-reported vs. assay-identified Chlamydia infection in young adults

Bonita Iritani, MA1, Denise Hallfors, PhD1, Carol A. Ford, MD2, Carolyn Tucker Halpern, PhD3, and William C. Miller, MD, PhD, MPH4. (1) Pacific Institute for Research and Evaluation, 1516 E. Franklin St., Ste 200., Chapel Hill, NC 27514, 919-265-2611, iritani@pire.org, (2) School of Medicine, Adolescent Medicine Program, Departments of Medicine and Pediatrics, University of North Carolina, CB #7220, Chapel Hill, NC 27599-7220, (3) Dept. of Maternal & Child Health, School of Public Health, University of North Carolina at Chapel Hill, 401 Rosenau Hall, CB# 7445, Chapel Hill, NC 27599-7445, (4) Department of Epidemiology, UNC School of Public Health, CB#7435 McGavran-Greenberg Hall, Chapel Hill, NC 27599-7435

Background: Population-based studies of Chlamydia prevalence often rely on self-reported infection, but self-reports miss infected individuals who are unscreened or asymptomatic. This study uses a population-based sample to (1) assess the prevalence of prior Chlamydia testing, and (2) compare Chlamydia prevalence estimates produced by self-reported infection (diagnosed in the past 12 months) to assay-identified infection. Methods: Data are from Wave 3 of the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of 18-26 year olds in the U.S. (N=14,322). Data include results of Chlamydia urine tests in addition to self-reports of past testing and diagnosis. Testing history, self-reported diagnosis and current test results are examined by biological sex and race-ethnicity. Ratio of assay-identified prevalence to self-report prevalence is calculated as an indicator of difference between the two measures. Results: Prevalence of testing is low; 25% of females and 8% of males were tested in the past year. Self-reported prevalence of a past-year Chlamydia diagnosis is 3% in comparison with a prevalence of 4% for biological test results that indicate infection at one point in time. Differences between self-reported versus assay-identified infection vary by demographic group. Conclusions: This study finds that only a minority of young adults were tested for Chlamydia in the past year and that the ratio of self-reports to assay-identified infections varies by demographic group. Implications regarding the adequacy of current levels of screening will be discussed, as will use of self-reported STI information to determine screening and/or STI prevention needs.

Learning Objectives:

Keywords: STD, Data/Surveillance

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.

Preventing 'Other' Sexually Transmitted Infections in Reproductive Health Programs: U.S. and International Perspectives

The 132nd Annual Meeting (November 6-10, 2004) of APHA