Sexually Transmitted Diseases

Skip Navigation LinksHome > May 2012 - Volume 39 - Issue 5 > Effects of Screening and Partner Notification on Chlamydia P...
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Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e31824e52c2
Original Study

Effects of Screening and Partner Notification on Chlamydia Positivity in the United States: A Modeling Study

Kretzschmar, Mirjam PhD*,†; Satterwhite, Catherine PhD; Leichliter, Jami PhD; Berman, Stuart MD

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Objectives: Model impact of increasing screening and partner notification (PN) on chlamydia positivity.

Methods: We used a stochastic simulation model describing pair formation and dissolution in an age-structured heterosexual population. The model accounts for steady, casual, and concurrent partnerships and a highly sexually active core group. The model used existing sexual behavior data from the United States and was validated using chlamydia positivity data from Region X (Alaska, Idaho, Oregon, Washington). A screening program with a coverage rate of 20% was implemented among women aged 15 to 24 years. After 10 years, we increased screening coverage to 35%, 50%, and 65% and partner treatment rates from 20% to 40% and 55%. Finally, we included male screening (aged 15–24, screening coverage: 20% and 35%, partner treatment: 25% and 40%). We analyzed the effects on chlamydia positivity in women and the frequency of reinfection 6 months after treatment.

Results: The model described the decline in positivity observed from 1988 to 1997 in Region X, given screening coverage of 20% and a 25% partner treatment rate. Increasing screening coverage from 35% to 65% resulted in incremental decreases in positivity as did increasing the PN rate; a 23% reduction in positivity was achieved by either increasing screening by 3-fold or PN by 2-fold. Adding male screening to the program had less impact than increasing screening coverage or PN among women. Increased PN and treatment reduced reinfection rates considerably.

Conclusions: Increasing efforts in PN may contribute at least as much to control of chlamydia infection as increasing screening coverage rates.

© Copyright 2012 American Sexually Transmitted Diseases Association


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