RT Journal Article
SR Electronic
T1 Incidence and reinfection rates of genital chlamydial infection among women aged 16–24 years attending general practice, family planning and genitourinary medicine clinics in England: a prospective cohort study by the Chlamydia Recall Study Advisory Group
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 292
OP 303
DO 10.1136/sti.2006.022053
VO 83
IS 4
A1 D Scott LaMontagne
A1 Kathleen Baster
A1 Lynsey Emmett
A1 Tom Nichols
A1 Sarah Randall
A1 Louise McLean
A1 Paula Meredith
A1 Veerakathy Harindra
A1 Jean M Tobin
A1 Gillian S Underhill
A1 W Graham Hewitt
A1 Jennifer Hopwood
A1 Toni Gleave
A1 Ajit K Ghosh
A1 Harry Mallinson
A1 Alisha R Davies
A1 Gwenda Hughes
A1 Kevin A Fenton
YR 2007
UL http://sti.bmj.com/content/83/4/292.abstract
AB Background: In England, screening for genital chlamydial infection has begun; however, screening frequency for women is not yet determined. Aim: To measure chlamydia incidence and reinfection rates among young women to suggest screening intervals. Methods: An 18-month prospective cohort study of women aged 16–24 years recruited from general practices, family planning clinics and genitourinary medicine (GUM) clinics: baseline-negative women followed for incidence and baseline-positive women for reinfection; urine tested every 6 months via nucleic acid amplification; and behavioural data collected. Extra test and questionnaire completed 3 months after initial positive test. Factors associated with infection and reinfection investigated using Cox regression stratified by healthcare setting of recruitment. Results: Chlamydia incidence was mean (95% CI) 4.9 (2.7 to 8.8) per 100 person-years (py) among women recruited from general practices, 6.4 (4.2 to 9.8) from family planning clinics and 10.6 (7.4 to 15.2) from GUM clinics. Incidence was associated with young age, history of chlamydial infection and acquisition of new sexual partners. If recently acquiring new partners, condom use at last sexual intercourse was independently associated with lower incidence. Chlamydia reinfection was mean (95% CI) 29.9 (19.7 to 45.4) per 100/person-year from general practices, 22.3 (15.6 to 31.8) from family planning clinics and 21.1 (14.3 to 30.9) from GUM clinics. Factors independently associated with higher reinfection rates were acquisition of new partners and failure to treat all partners. Conclusions: Sexual behaviours determined incidence and reinfection, regardless of healthcare setting. Our results suggest annual screening of women aged 16–24 years who are chlamydia negative, or sooner if partner change occurs. Rescreening chlamydia-positive women within 6 months of baseline infection may be sensible, especially if partner change occurs or all partners are not treated.