Original article
Prevalence and correlates of chlamydia infection in Canadian street youth

https://doi.org/10.1016/j.jadohealth.2003.07.017Get rights and content

Abstract

Purpose

To determine the prevalence and correlates of Chlamydia trachomatis in Canadian street youth.

Methods

A cross-sectional study of street youth between the ages of 15–24 years was conducted over a 9-month period in seven large urban centers across Canada. Youth were recruited through “drop-in” centers, outreach work, and mobile vans in each city. Information was collected through a nurse-administered questionnaire. Youth were asked to provide urine to test for chlamydia trachomatis by polymerase chain reaction. Separate logistic regression models were run for males and females controlling for age.

Results

The prevalence rate of chlamydia was 8.6% in 1355 youth (95% CI = (7.1%, 10.1%)). Higher prevalence rates were found in females than in males (10.9% vs. 7.3%, respectively) and in Aboriginal youth than in non-Aboriginal youth (13.7% vs. 6.6%, respectively). Four variables were associated with increased risk of chlamydia infection in females: Aboriginal status; self-perceived risk; having no permanent home; and having been in foster care. One predictor of chlamydia for males was having had a social worker.

Conclusions

A high prevalence of chlamydia was found in this vulnerable population in comparison to other Canadian youth. Having been in foster care and having had a social worker were found to have a strong association with chlamydia.

Section snippets

Study design

A baseline cross-sectional study was conducted over a 9-month period from February to October 1999 in seven large urban centers across Canada (Vancouver, British Columbia; Edmonton, Alberta; Saskatoon, Saskatchewan; Winnipeg, Manitoba; Toronto, Ontario; Ottawa, Ontario; Halifax, Nova Scotia).

Recruitment of youth involved snowball sampling methods, in which news of the study was advertised verbally to potential participants without the use of specific geographic sampling frames or named

Results

From February to October 1999, 1733 youth were recruited. Three-hundred-and-seventy-eight participants were excluded either because they had never had any sexual encounters or they provided no, or insufficient, urine for testing. Of the remaining 1355 youth, 867 males and 488 females were assessed, 91.4% reporting being born in Canada with an overall mean age of 18.8 years (SD = 2.5). No statistical differences in gender, age, or sexual risk behaviors were found between those retained and those

Discussion

The C. trachomatis prevalence rate of 8.6% in our sample of street youth is almost 9 times that reported in the general Canadian youth population of 15–24 year-olds [21]. With an estimated 150,000 Canadian street youth [22] and many cases of chlamydia remaining undetected, a hidden epidemic exists in this population. School-based interventions do not reach these youth, because they often leave school prematurely. In addition, many street youth do not present themselves to physicians for

Acknowledgements

This work was funded by The Division of Community Acquired Infections, Centre for Infectious Disease Prevention and Control, Health Canada.

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