Trends in chlamydia and other sexually transmitted diseases in a university health service

The incidence of sexually transmitted diseases in a primarily student-based patient population served by a university health service was reviewed because of the perception that the number of positive chlamydia tests was declining. The most striking finding that emerged was that there was, indeed, a persistent and steady decline in the rates of chlamydia infection over the study time period of 1989 to 1994. Other sexually transmitted diseases showed less definite declines or no significant change. The authors evaluated the number of positive chlamydia tests in the health service with symptoms suggestive of chlamydia infection. Of all university health service patients who tested positive for chlamydia, 48.8% were asymptomatic. A majority (75.2%) of the female patients who tested positive on their annual routine family-planning examination were also asymptomatic for chlamydia. Chlamydia-positive men presenting to the health service were far more likely to be symptomatic than were the women who were positive. Overall, a significant decrease in chlamydia occurred over the 5-year period in spite of an increasing enrollment, a fact that could perhaps be attributable to students' increased awareness of the risk of sexually transmitted infections and their use of condoms.