Abstract
Objectives Studies conducted in the 1980s, when there was limited chlamydia screening, showed high positivity, 23%–30%, among American Indian women. In the 1990s, chlamydia screening and treatment programs were implemented in a variety of settings serving American Indian women including Indian Health Service (IHS) clinics. Yet, a 2000–2001 national survey documented a chlamydia prevalence of 13.3% among young American Indian women, five times higher than the prevalence among whites. The purpose of this analysis was to determine the chlamydia positivity and risk factors for chlamydia among women screened in Indian Health Service (IHS) clinics participating in the National Infertility Prevention Program in 2003. Methods Data were analyzed from 11,485 chlamydia tests performed among women universally screened in 23 IHS clinics in three states (Montana, North Dakota, South Dakota). Sexual risk history and clinical data were collected in the Montana IHS clinics and used to assess risk factors for chlamydial infection in a multivariate logistic regression model. Results Chlamydia positivity was highest among 15–19 year old women screened in IHS clinics (state range: 15.3%–18.6%). Positivity decreased with age but remained high even among women aged 30–34 years. Young age and having had multiple or new sex partners in the last 90 days were associated with an increased risk of chlamydia; however, chlamydia positivity was greater than 6.7% for women with no known risk factors. Conclusions A greater emphasis on chlamydia screening and treatment should be a component of any program whose goal is to improve the reproductive health of American Indian women.
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References
Cates, W. Jr., & Brunham, R. C. (1999). Sexually transmitted diseases and infertility. In K. K. Holmes, P. F. Sparling, & P.-A. Mardh et al. (Eds.) Sexually transmitted diseases (3rd ed. pp. 1079–1087). New York: McGraw-Hill Health Professions Division.
Centers for Disease Control and Prevention. (2003). Sexually transmitted disease surveillance. Atlanta: U.S. Department of Health and Human Services, September 2004.
Weinstock, H. et al. (2004). Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health, 36, 6–10.
Stamm, W. E. (1999). Chlamydia trachomatis infections of the adult. In Holmes, K. K., Sparling P. F., & Mardh P.-A. et al. (Eds.). Sexually transmitted diseases (3rd ed. pp. 407–422). New York: McGraw-Hill Health Professions Division.
Harrison, H. R. et al. (1983). The prevalence of genital Chlamydia trachomatis and mycoplasmal infections during pregnancy in an American Indian population. Sexually Transmitted Diseases, 10(4), 184–186.
Toomey, K. E. et al. (1987). Unrecognized high prevalence of Chlamydia trachomatis cervical infection in an isolated Alaskan Eskimo population. JAMA, 258(1), 53–56.
Cullen, T. A. et al. (1990). Chlamydia trachomatis infection in Native American women in a southwestern tribe. Journal of Family Practice, 31(5), 552–554.
Miller, W. C. et al. (2004). Prevalence of chlamydial and gonococcal infections among young adults in the United States. JAMA, 291(18), 2229–2236.
Hillis, S. et al. (1995). New opportunities for chlamydia prevention: applications of science to public health practice. Sexually Transmitted Diseases, 22, 197–202.
Dicker, L. W., Mosure, D. J., & Levine, W. C. (1998). Chlamydia positivity versus prevalence: What’s the difference? Sexually Transmitted Diseases, 25, 251–253.
Centers for Disease Control and Prevention. (2006). Sexually transmitted diseases treatment guidelines. MMWR, 55(RR–11), 40.
Guide to Clinical Preventive Services, 2005. AHRQ Publication No. 05–0570, June 2005. Agency for Healthcare Research and Quality. Rockville (http://www.ahrq.gov/clinic/pocketgd.htm).
Mosure, D. J. et al. (1997). Genital chlamydia infections in sexually active female adolescents: Do we really need to screen everyone? Journal of Adolescent Health, 20, 6–13.
Finelli, L. et al. (1996). Selective screening versus presumptive treatment criteria for identification of women with chlamydial infections in public clinics: New Jersey. American Journal of Obstetrics and Gynecology, 174, 1527–1533.
Mosure, D. J. et al. (1996). Predictors of Chlamydia trachomatis infection among female adolescents: A longitudinal analysis. American Journal of Epidemiology, 144, 997–1003.
Marrazzo, J. M. et al. (1997). Selective screening for chlamydial infection in women: A comparison of three sets of criteria. Family Planning Perspectives, 29, 158–162.
Barnes PM, et al. (2005). Health characteristics of the American Indian and Alaska Native adult population: United States, 1999–2003. Advance data from vital and health statistics; no. 356. Hyattsville: National Center for Health Statistics.
Acknowledgements
The authors would like to thank the following people for their help with the collection of the data from the Indian Health Service clinics and their review of this manuscript: Yvonne Hamby, JSI Research and Training Institute, Denver, CO; Laurie Kops and Susanne Zanto, Montana Department of Public Health, Helena, MT; Kirby Kruger, North Dakota Department of Health, Bismarck, ND; and Dave Morgan, South Dakota Department of Health, Pierre, SD.
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Dicker, L.W., Mosure, D.J., Kay, R.S. et al. An Ongoing Burden: Chlamydial Infections among Young American Indian Women. Matern Child Health J 12 (Suppl 1), 25–29 (2008). https://doi.org/10.1007/s10995-007-0293-1
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DOI: https://doi.org/10.1007/s10995-007-0293-1