Social and behavioral correlates of pelvic inflammatory disease.
OBJECTIVE
To review the social and behavioral correlates of pelvic inflammatory disease (PID) in the light of the renewed interest in the transmission dynamics of communicable diseases, the new emphasis on health care seeking and health service provision, and increased attention to contextual and population level factors affecting morbidity.


METHODS
Social and behavioral correlates of PID are reviewed using a conceptual scheme that matrixes the differences among risk factors for exposure, acquisition, and development of sequelae with the differences between individual-level risk factors and population-level determinants.


RESULTS
Two major factors contribute to the development of PID: recurrent (or persistent) chlamydial infection of the cervix, which are geographically concentrated and associated with contextual variables, and critical delays in detection and treatment of cervical infection, which are amenable to interventions.


CONCLUSIONS
Widespread screening for cervical infection followed by timely and appropriate treatment is key for prevention of PID. Health care seeking, provider training, and availability of detection technologies and drugs need to be improved.
Aral
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Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Wasserheit
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JN
D002690:Chlamydia Infections / Q000150:complications; D005260:Female; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000209:etiology* / Q000517:prevention & control; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000209:etiology / Q000517:prevention & control; D012919:Social Behavior; D002577:Uterine Cervical Diseases / Q000150:complications