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Acquisition of Chlamydia trachomatis by Young Women During Their First Year of Military Service

SHAFER, MARY-ANN B. MD*; BOYER, CHERRIE B. PhD*; POLLACK, LANCE M. PhD; MONCADA, JEANNE MT; CHANG, Y JASON MS; SCHACHTER, JULIUS PhD

Sexually Transmitted Diseases: March 2008 - Volume 35 - Issue 3 - p 255-259
doi: 10.1097/OLQ.0b013e31815c1bd0
Article

Objectives: To define the acquisition rate of Chlamydia trachomatis among a cohort of young, nonhealth-care seeking, sexually active women with well-defined exposure periods over a 12-month period.

Goal: The long-term goal is to inform public health practitioners and young women of the risk of reinfection with C. trachomatis and the need for frequent active screening to eliminate asymptomatic infections over time.

Study Design: Young sexually active female Marine Corps recruits (N = 332), serving as “controls” for an intervention to prevent sexually transmitted infections, were screened for C. trachomatis using nucleic acid amplification tests (treated if positive) at entry (T1). They were rescreened and completed self-report behavioral surveys at 4 weeks (T2) and 9 to 12 months (T3) from recruit training.

Main Outcome Measure: The rate of C. trachomatis acquisition during a contiguous 12-month period.

Results: Based on microbiologic laboratory testing alone, the acquisition rate for C. trachomatis was 3.6% (T2) and 9.9% (T3) yielding a total of 13.0%. The self-reported acquisition rate for the period since graduation from recruit training was 8.1% yielding a total acquisition rate of 19.9%.

Conclusions: The acquisition rate among this cohort of nonhealth-care seeking young women, who have universal health care access is as high or higher than most clinic-based studies, suggesting the need for increased implementation of active screening in primary, urgent, and nonclinic settings.

The Chlamydia trachomatis acquisition rate remains high among sexually active young adults, emphasizing the need to educate young women and have active screening programs that extend beyond traditional clinic settings.

From the *Department of Pediatrics, Division of Adolescent Medicine; †Center for AIDS Prevention Studies; and ‡Department of Laboratory Medicine, University of California, San Francisco, California.

Supported by Department of Defense Grant under the Women's Health Initiative (DAMD17-95-C-5077) from funds allocated to the United States Army Medical Research and Materiel Command, Fort Detrick, MD, and in part by the Leadership Education in Adolescent Health (LEAH), Maternal and Child Health Bureau (Grant MCH000978) who, in part, supported Drs. Shafer and Boyer.

The sources of funding had no role in the study design, collection, analysis, and interpretation of data nor in the writing or decision to submit the article for publication.

Correspondence: Mary-Ann B. Shafer, MD, Department of Pediatrics, Division of Adolescent Medicine, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA 94941. E-mail: shaferm@peds.ucsf.edu.

Received for publication May 10, 2007, and accepted September 19, 2007.

© Copyright 2008 American Sexually Transmitted Diseases Association