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Risk factors for recurrent Chlamydia trachomatis infections in women
S D Hillis1, A Nakashima, P A Marchbanks
1Division of Sexually Transmitted Diseases/Human Immunodeficiency Virus Prevention, National Center for Prevention Services, Atlanta, Georgia.
Objective:
We evaluated risk factors for recurrent Chlamydia trachomatis infections in women.
Study Design:
We used a retrospective cohort design to examine predictors of recurrent infection in the 38,866 female residents of Wisconsin whose first reported C. trachomatis infection occurred between 1985 and 1989.
Results:
Young age at first reported infection was the strongest predictor of recurrent C. trachomatis infection, after adjustment for covariates. Adolescents < 15 years old had an eightfold increased risk, those 15 to 19 years old had a fivefold increased risk, and women 20 to 29 years old had a twofold increased risk of recurrent C. trachomatis infection, compared with that among women 30 to 44 years old. In 54% of those aged < 15 at initial infection and 30% of those aged 15 to 19, recurrence developed. Other characteristics associated with recurrence included black race, residence in Milwaukee County, coinfection with gonorrhea, and past sexually transmitted diseases; receiving care in a family-planning clinic appeared protective.
Conclusions:
Implementation of strategies to reduce the markedly elevated risk of recurrent chlamydia infections is urgently needed in female adolescents.