Recurrent chlamydial infections among young women in rural and urban environments

Purpose: To observe epidemiologic patterns of recurrent chlamydial infections and health disparities in geographical settings

Method: A cross-sectional study was conducted on 60,000 randomly selected women who attended family planning, STD and prenatal clinics in eight southeastern states between 1999 and 2000. Each client was screened for chlamydial infection using the Nuclei Acid Probe. Clients were between the ages of 10 and 24 years and were categorized into rural and urban areas. The mean distance from each client's residence to the clinic providing services was calculated to evaluate physical access to care. Chi square analysis and the logistic regression model were used to determine correlations among age, race and distance.

Results: A total of 6,640 women were infected with chlamydia and 842 were reinfected during the study period. In urban areas, 16 to 19 year old women were more likely to be reinfected than 20 to 24 year old women. In rural areas, Black women were 2.26 times more likely to be reinfected than Whites (p<.05). In urban areas, Black women were 1.35 times more likely to be reinfected than Whites (p<.05). Rural clients residing further away from the clinic were 24.2% more likely to be reinfected (p=0.006). Overall, rural clients were more likely to have a recurrent chlamydia infection.

Conclusion: Increased health services are needed to reduce health disparities in rural environments.