Chlamydia More Likely in Youngest PID Patients


CHICAGO — Young women with pelvic inflammatory disease are more likely than older women to test positive for chlamydia and gonococcal infections, Dr. Joan Chow of the California Department of Public Health reported.

Although the overall prevalence of chlamydia was only 12%, 21% of women younger than 20 years tested positive for the infection, compared with 16% of women aged 21–25 years, and just 5% of those older than 25 years. Gonococcal infections also were significantly more common in the youngest women, Dr. Chow said at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

“The significantly higher chlamydia and gonococcal prevalence among younger cases of PID [pelvic inflammatory disease] suggests that the etiology of PID in women older than 25 may be different than it is in younger women. This is consistent with the very low levels of cervical chlamydia and gonococci that we consistently observe among older women in national and local prevalent monitoring data.”

Dr. Chow's cross-sectional analysis drew on two sources of data: paid claims from California's Family Planning, Access, Care, and Treatment (FPACT) program, which serves low-income women, and linked test data from Quest Diagnostics, which account for about 18% of all chlamydia testing in the program.

Of the 381 women with PID included in the analysis, 22% were younger than 20 years, 29% were aged 21–25 years, and the rest were older than 25 years. More than half (56%) were Hispanic, 28% were white, and 5% were black. Other racial groups made up the remainder of the patient population.

Chlamydia prevalence was highest in the youngest women (21%). Among those aged 21–25 years, prevalence was 16%, dropping to 5% in those older than 25 years.

In a comparator group of 333,000 FPACT patients without PID, chlamydia prevalence was 6% in those younger than 20 years, 5% in the 21- to 25-year-olds, and 2% in those older than 25 years.

Gonorrhea prevalence also was highest in those younger than 20 years (4%) in the group with PID. Prevalence was 2% in the 21- to 25-year-olds and 1% in those older than 25 years.

In the comparator group without PID, gonorrhea prevalence was less than 1% in each age group.

The findings stress the importance of following national guidelines for annual screening in women younger than 25 years, Dr. Chow said at the meeting.

“While chlamydia screening has increased since the release of the recommendations, screening is still only reaching about 50% of sexually active young women,” she noted.


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