181508 Untreated chlamydial infection among adolescents and young adults in Baltimore, MD, USA

Monday, October 27, 2008: 10:50 AM

Elizabeth Eggleston, DrPH , Health and Behavior Measurement Program, Research Triangle Institute, Washington, DC
Susan M. Rogers, PHD , Statistics and Epidemiology, Research Triangle Institute, Washington, DC
Charles F. Turner, PhD , Health and Behavior Measurement Program, Research Triangle Institute, Washington, DC
Anthony Roman, MA , Center for Survey Research, University of Massachusetts-Boston, Boston, MA
Sylvia Tan, MS , Research Triangle Institute, Washington, DC
Emily Erbelding, MD, MPH , Division of Infectious Disease, Johns Hopkins Medical Institutions, Baltimore, MD
Chlamydia is the most frequently reported bacterial sexually transmitted disease in the U.S. It is the leading cause of female infertility and is associated with epididymitis and infertility among men. Chlamydia may increase the likelihood of HIV/AIDS transmission in both sexes.

Reported rates of chlamydia reflect cases detected and treated by providers and laboratories. Substantial under-reporting of chlamydia is likely because most (50-75%) infections are asymptomatic and thus remain undetected and untreated.

The Monitoring STIs study monitors the prevalence of three sexually transmitted infections -- gonorrhea, chlamydia, and trichomoniasis -- among a probability sample of adolescents and young adults (15-35 years) in Baltimore, MD. The study uses telephone surveys combined with testing of self-collected mail-in urine specimens. Data collection began September 2006.

In this paper we report findings from the first year of survey sampling on the prevalence and correlates, demographic and behavioral, of untreated chlamydial infection. We also compare our survey results to the number of infections reported to Baltimore City Health Department (BCHD) during the same time period.

Preliminary Results.

1109 Baltimore residents, aged 15-35 years, were surveyed. 70% provided a urine specimen, and 4.8% tested positive for chlamydia. Prevalence was higher among black participants than among whites 7.0% v. 1.5%. Unexpectedly, prevalence was also higher among males than among females 6.1% v. 3.5% --suggesting the need for increased screening among males.

Analyses of BCHD data suggest that undiagnosed, untreated Ct infections among 15-35 year-olds exceed the number of reported and treated infections by a factor of 1.4.

Learning Objectives:
1. Define the prevalence of untreated chlamydia among adolescents and young adults (aged 15-35) in Baltimore, MD. 2. Identify the demographic and behavioral factors associated with chlamydial infection among 15-35 year-olds in Baltimore. 3. Assess the limitations of current systems of STD surveillance. 4. Develop STD screening priorities in Baltimore MD.

Keywords: Chlamydia, Youth

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have neither a relevant financial relationship with a commercial interest occurring within the past 12 months nor the opportunity to affect the content of CE about the products or services of any commercial interest.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.