Prevalence, incidence, and correlates of chlamydia and gonorrhea among young adult injection drug users.
OBJECTIVE
To measure prevalence, incidence, and correlates of chlamydia and gonorrhea among injection drug users (IDUs).


METHODS
Participants (n = 2129; 63% male, 52% white, ages 18-30 years) in five US cities were tested for chlamydia and gonorrhea by urine LCR assay and completed a standardized questionnaire about demographics and recent sexual behavior. Logistic regression identified correlates of prevalent infection; incidence rates were calculated from 6-month follow-up data.


RESULTS
Chlamydia prevalence was 5.2% and did not differ by gender. Gonorrhea prevalence was 0.2% among men and 2.0% among women, P < .001. Among men, younger age [OR (95% CI): 0.89 (0.83-0.96)], age at sexual debut [0.91 (0.83-0.99)], and African American race [2.92 (1.53-5.59)] were associated with chlamydia. Among women, age at sexual debut [1.16 (1.02-1.31)] and commercial sex [1.96 (1.03-3.74)] were associated with chlamydia, and with gonorrhea [1.27 (1.04-1.56)] and [5.17 (1.66-16.11)], respectively. At 6 months, the cumulative incidence of chlamydia was 1.7% among men and 4.4% among women, P = .03; no men and 1.3% of women tested positive for gonorrhea, P = .01.


CONCLUSIONS
Prevalence and correlates of chlamydia and gonorrhea were similar to other samples, suggesting that screening criteria need not be modified for IDU populations. The number of behavioral correlates identified was limited; perhaps unmeasured sexual-network-level factors play a role in determining sexually transmitted disease (STD) prevalence.
Latka
M
M
Center for Urban Epidemiologic Studies, Room 556, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, USA. mlatka@nyam.org
Ahern
J
J
Garfein
R S
RS
Ouellet
L
L
Kerndt
P
P
Morse
P
P
Farshy
C E
CE
Des Jarlais
D C
DC
Vlahov
D
D
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000652:urine*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000652:urine*; D006801:Humans; D015994:Incidence; D022521:Ligase Chain Reaction; D008297:Male; D015995:Prevalence; D017678:Sex Distribution; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014481:United States