NAAT-identified and self-reported gonorrhea and chlamydial infections: different at-risk population subgroups?
BACKGROUND
Information on the characteristics and behaviors of persons at high risk for gonorrhea and chlamydial infection has typically been derived from studies of sexually transmitted disease (STD) clinic populations. The Baltimore STD and Behavior Survey (BSBS) used urine-based nucleic acid amplification testing (NAAT) to assess the prevalence and behavioral correlates of gonorrhea and chlamydial infection in a population-based cross-sectional survey of adults in Baltimore, Maryland.


OBJECTIVE
The goal of this study was to examine the demographic characteristics and behavioral markers of gonorrhea and chlamydial infection as reported by adults with a self-reported history of gonorrhea and chlamydial infection and to compare these to the characteristics and behaviors of individuals with current NAAT-identified gonorrhea and/or chlamydial infection.


METHODS
A probability sample of adults aged 18 to 35 years residing in Baltimore was evaluated with collection of urine specimens and administration of a health and behavior survey. Data and specimens were collected between January 1997 and September 1998.


RESULTS
Respondents with NAAT-detected gonorrhea and/or chlamydial infection (7.9%) did not report a history of high-risk behaviors or more recent occurrences of those behaviors, and the majority were asymptomatic. However, adults in our study who self-reported a history of infection (26.0%) were more likely than those with no history of infection to report multiple partners, paid sex, partners with prior STDs, and STD symptoms-a pattern consistent with findings described in previous clinic-based reports.


CONCLUSIONS
The risk profile generated from studies of clinic populations, with a focus on symptomatic disease, may not characterize the broader population with current, untreated, largely asymptomatic infection.
Rogers
Susan M
SM
Program in Health and Behavior Measurement, Research Triangle Institute, Washington, DC 20036, USA. smr@rti.org
Miller
Heather G
HG
Miller
William C
WC
Zenilman
Jonathan M
JM
Turner
Charles F
CF
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000652:urine; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification*; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000032:analysis; D003625:Data Collection; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000235:genetics / Q000302:isolation & purification*; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D016017:Odds Ratio; D012307:Risk Factors; D012650:Self Disclosure; D012725:Sexual Behavior; D012747:Sexual Partners
D004269:DNA, Bacterial