Article Text

Download PDFPDF
Original article
Multiple chlamydia infection among young women: comparing the role of individual- and neighbourhood-level measures of socioeconomic status
  1. Katie Brooks Biello1,2,
  2. Melinda M Pettigrew1,2,
  3. Linda M Niccolai1,2
  1. 1Yale School of Public Health, New Haven, Connecticut, USA
  2. 2Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut, USA
  1. Correspondence to Katie Brooks Biello, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA; katie.biello{at}


Background Young women have the highest burden of chlamydia infections, and socioeconomic disparities exist. Individual-level measures of socioeconomic status (SES) may be difficult to assess for young women. The authors examined whether neighbourhood SES provides a useful measure in comparison with individual-level SES with respect to the burden of multiple chlamydia diagnoses.

Methods In a study of young women with chlamydia (n=233; mean age =21 years), multiple infections were assessed with self-report and follow-up testing. General estimating equations and pseudo-R2 were used to assess the roles of individual-level SES (education and employment) and neighbourhood-level SES (percentage of people in census tract of residence below poverty) on multiple chlamydia diagnoses.

Results Neither education nor employment was associated with multiple chlamydia diagnoses. Women living in high-poverty areas were significantly more likely than those living in low-poverty areas to have multiple chlamydia diagnoses (adjusted OR 3.46, 95% CI 1.18 to 10.15). This neighbourhood-level poverty measure improved model fit by 17%.

Conclusions Neighborhood-level poverty may provide a better measure of SES than individual-level variables as a predictor of multiple chlamydia diagnoses in young women and can be useful when valid measures of individual-level SES are unavailable.

  • Chlamydia
  • sexually transmitted infections
  • socioeconomic status
  • female
  • adolescent
  • epidemiology (general)
  • race issues
  • sexual behaviour
  • social science
  • epidemiology
  • risk factors
  • STD patients
  • STD clinic
  • STDS

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding Sources of support for this work include The Donaghue Medical Research Foundation (grant number DF03-040) and National Institute of Mental Health at the National Institutes of Health (grant numbers P30NIMH62294 and T32MH020031—Center for Interdisciplinary Research on AIDS at Yale). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH or the NIH.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Yale University School of Medicine Human Investigation Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.