Gonorrhea and chlamydia infection among women visiting family planning clinics: racial variation in prevalence and predictors.
BACKGROUND
Black women are disproportionately infected with gonorrhea and chlamydia. Because of the potential impact of these infections on women's reproductive health, it is important to determine whether different factors are predictive of infection in women of different races.


METHODS
Data from 31,762 women aged 15-24 who were tested for gonorrhea and chlamydia at Missouri family planning clinics in 2001 were used to calculate the prevalence of each infection by selected variables. Logistic regression analysis was used to assess factors associated with the risk of infection.


RESULTS
Overall, 0.7% of women had gonorrhea, and 4% had chlamydia. The gonorrhea rate was 4% for blacks and 0.4% for whites; the chlamydia rate, 9% and 4%, respectively. Independent predictors of gonorrhea in both races were symptoms, recent sexual contact with a partner who had STD symptoms, and chlamydia infection. Predictors specific to whites were visiting the clinic for STD care and having a new partner or multiple partners in the past year. Being aged 15-21 was associated with an elevated risk of gonorrhea for blacks only. In both racial groups, chlamydia infection was associated with younger age, contact with a symptomatic partner, cervicitis, cervical friability and gonorrhea positivity. Additional predictors among whites were having a new partner, having multiple partners and having pelvic inflammatory disease; no other factors were significant for blacks.


CONCLUSIONS
The prevalence and predictors of gonorrhea and chlamydia infection differ significantly between blacks and whites. Until these disparities are better understood, it will be difficult to establish screening criteria for gonorrhea.
Einwalter
Lisa A
LA
University of Iowa, College of Public Health, Iowa City, IA, USA. lisa-einwalter@uiowa.edu
Ritchie
Justine M
JM
Ault
Kevin A
KA
Smith
Elaine M
EM
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D016009:Chi-Square Distribution; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D006266:Health Education / Q000592:standards; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000706:statistics & numerical data; D008923:Missouri / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data*; D016387:Women's Health