title: Assessment of risk for pelvic inflammatory disease in an urban sexual health population.
abstract: OBJECTIVE
  To determine the sexual and demographic risk factors for the acquisition of presumptive pelvic inflammatory disease (PID).
  
  
  METHODS
  A retrospective, case-control study in women, who attended the Sydney Sexual Health Centre (SSHC), between April 1991 and December 1997. Logistic regression analysis was used to adjust for confounding variables.
  
  
  RESULTS
  741 women with PID and an equal number of controls were included. Cases were significantly younger than controls (p < 0.001). 42% of cases were born in north or South East Asia, compared with 12% of the controls (p < 0.001). The adjusted odds ratio for being born in north or South East Asia was 2.8 (95% CI 1.70-4.46), for not speaking English at home was 1.6 (95% CI 1.02-2.55), for having had previous PID was 5.9 (95% CI 3.59-9.73), and for being employed in the commercial sex industry and being born in north or South East Asia was 2.8 (95% CI 1.22-6.22). Women aged 15-19 were at considerable risk of developing PID (OR 5.3 (95% CI 2.76-10.11)). Women with previous human papillomavirus infection were significantly less likely to develop PID (OR 0.6 (95% CI 0.42-0.79)). The use of IUCDs (OR 4.5 (95% CI 2.14-9.39)), condoms (OR 1.4 (95% CI 1.03-1.87)), and not using contraception (OR 1.8 (95% CI 1.20-2.76)) was each associated with an increased risk.
  
  
  CONCLUSIONS
  Several measures may help to reduce the burden of PID. Women should be encouraged to delay the onset of sexual activity and IUCDs should not be used in young women. Sexual health services for women whose home language is not English, and for commercial sex workers born in north or South East Asia should be improved.
authors.affiliation: Sexually Transmitted Infections Research Centre, Marion Villa, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Marks
authors.forename: R L
authors.initials: RL
authors.lastname: Tideman
authors.forename: C S
authors.initials: CS
authors.lastname: Estcourt
authors.forename: G
authors.initials: G
authors.lastname: Berry
authors.forename: A
authors.initials: A
authors.lastname: Mindel
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001208:Asia / Q000208:ethnology; D016022:Case-Control Studies; D017280:Condoms / Q000009:adverse effects; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects; D008875:Middle Aged; D015999:Multivariate Analysis; D000292:Pelvic Inflammatory Disease / Q000208:ethnology / Q000209:etiology*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000150:complications; D012907:Smoking / Q000009:adverse effects; D014504:Urban Health / Q000706:statistics & numerical data*