Fewer at-risk women getting tested for chlamydia.

There are 19 million new sexually transmitted infections (STIs) in the US every year. Even though young people make up only a quarter of the sexually active population, half of all these infections occur in young people aged 15 -24.1 In addition to the immediate and long term consequences, the direct medical cost of sexually transmitted diseases in the United States is about $17 billion annually.2

Chlamydia is the most common bacterial STI in the US. Each year, over 1 million cases are reported to the CDC.3 Young people especially young women and teens are at an increased risk for STDs when compared to older adults. Young people aged 15-24 years have four times the reported rate of chlamydia of the total population.3 According to the most recent estimates, 18-20 year-old females continue to have higher rates of chlamydia than any other age-sex group. 3 In men, the highest rates of reported chlamydia infections are among 20-24 year olds.3

Most STIs can occur without symptoms and many of those infected may keep spreading the infection unknowingly. Like most STIs, a chlamydia infection does not cause symptoms. Because so few people have symptoms of the infection, they do not know that they have an STI and do not go to the doctor to be treated.
Without symptoms, infected people can spread the chlamydia infection to their sexual partners without knowing it. Infected males who remain untreated frequently re-infect their female partners.
Without screening, many infected women remain untreated. Chlamydia infection can spread to the female reproductive organs causing chronic pain, pelvic inflammatory disease (PID), infertility, and the risk of ectopic pregnancy.

Women who are infected with chlamydia are more likely to become infected with HIV when exposed.4 Chlamydia is curable if detected early but a recent CDC report shows that many women who are at risk of this infection are not being tested for the infection.4,5 It is estimated that three out of five sexually active women aged 15 to 25 in the United States have not being tested within the past year for chlamydia as is recommended by the CDC.5

Sexually active young women aged 25 and under should be screened for chlamydia every year and retested 3 months following treatment, after a positive screening test. Pregnant women should be tested for chlamydia infection during pregnancy to prevent the spread of chlamydia infection to their babies.
Even with consistent condom use, one can only decrease the risk of infection by about half.6,7 Chlamydia can be prevented by refraining from sexual activity until a person is in a life-long, faithful relationship with an uninfected partner.

References:
1. Weinstock H, Berman S and Cates W, Jr., Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004; 36(1):6-10.

2. Chesson HW, Gift TL, Owusu-Edusei K, Tao G, Johnson AP, Kent CK. A brief review of the estimated economic burden of sexually transmitted diseases in the United States: Inflation-adjusted updates of previously published cost studies. Sex Transm Dis 2011; 38(10): 889-891.

3. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2010. Atlanta, GA: U.S. Department of Health and Human Services. 2011. Available at: http://www.cdc.gov/std/stats10/surv2010.pdf. Accessed April 11, 2012.

4. Centers for Disease Control and Prevention. Chlamydia – CDC fact sheet. Available at http://www.cdc.gov/std/chlamydia/STDFact-Chlamydia.htm Accessed April 11, 2012.

5. Hoover K, Tao G, Leichliter J, Peterman T. Self-Reported Chlamydia Testing of Women in the United States, 2006-2008. Oral presentation D6.4, 2012 National STD Prevention Conference, Minneapolis, Minnesota, March 15, 2012.

6. Warner L, Stone KM, Macaluso M, Buehler JW, Austin HD. Condom use and risk of gonorrhea and chlamydia: A systematic review of design and measurement factors assessed in epidemiologic studies. Sex Transm Dis 2006; 33(1):36-51.

7. Ahmed S, Lutalo T, Wawer M, et al. HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai, Uganda. AIDS. 2001; 15(16):2171-2179.

Reviewed: April 2012

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