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Asymptomatic sexually transmitted diseases: the case for screening.
Thomas A Farley1, Deborah A Cohen, Whitney Elkins
1Louisiana Office of Public Health, and the Department of Community Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. tfarley@tulane.edu
Preventive Medicine
|March 22, 2003
Summary
Many gonorrhea and chlamydial infections go untreated because they lack symptoms. Routine screening is crucial for controlling these common sexually transmitted diseases.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- The US faces a high prevalence of sexually transmitted diseases (STDs).
- Effective control requires understanding why curable STDs remain untreated.
Purpose of the Study:
- To estimate the prevalence of gonorrhea and chlamydial infections.
- To identify reasons for undertreatment of these infections.
Main Methods:
- 1,631 individuals aged 18-29 were screened for gonorrhea and chlamydia.
- Surveys and medical record reviews assessed past symptoms and treatment history.
- Prevalence, treatment rates, and reasons for nontreatment were calculated.
Main Results:
- Gonorrhea prevalence was 2.3%; chlamydial infection prevalence was 10.1%.
- A significant proportion of infections were asymptomatic (45% gonorrhea, 77% chlamydia).
- Most untreated cases (86% gonorrhea, 95% chlamydia) were asymptomatic; a small percentage resulted from lack of medical care for symptoms.
Conclusions:
- The primary barrier to treating gonorrhea and chlamydia is the lack of symptoms.
- Routine screening at high-volume locations is the most effective control strategy.