title: Lifetime interpersonal violence and self-reported chlamydia trachomatis diagnosis among California women.
abstract: OBJECTIVE
  To examine the relationship between cumulative exposure to various types of interpersonal violence throughout the life span and self-reported history of Chlamydia trachomatis (CT) diagnosis in a population-based sample of California women.
  
  
  METHODS
  This was a cross-sectional analysis of a population-based survey of California women aged 18-44 years (n = 3521). Participants reported their experience of multiple types of interpersonal violence: physical or sexual abuse in childhood or adulthood and intimate partner violence (IPV) in the past 12 months. Current posttraumatic stress disorder (PTSD) and depressive symptoms were also reported. Separate logistic regression models assessed the association between experiencing each type of interpersonal violence, as well as women's cumulative exposure to violence, and past CT diagnosis, adjusting for age, race/ethnicity, and poverty, as well as mental health problems.
  
  
  RESULTS
  Six percent of women reported a past diagnosis of CT, and 40.8% reported experiencing at least one type of interpersonal violence in their lifetime. All types of violence were significantly associated with higher odds of having a past CT diagnosis even after controlling for sociodemographics. Women who reported experiencing four or more types of violence experiences had over five times the odds of reporting a lifetime CT diagnosis compared with women who never experienced interpersonal violence (adjusted odds ratio = 5.71, 95% CI 3.27-9.58). Current PTSD and depressive symptoms did not significantly affect the relationship between a woman's cumulative experience of violence and her risk of past CT diagnosis.
  
  
  CONCLUSIONS
  There is a robust association between experiencing multiple forms of violence and having been diagnosed with CT. Women who seek treatment for sexually transmitted diseases (STDs), such as CT, should be assessed for their lifetime history of violence, especially violence in their current intimate relationships. Sexual risk reduction counseling may also be important for women who have a history of risky sexual behaviors and who are likely to be reinfected.
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA 94025, USA. Jennifer.Alvarez@va.gov
authors.forename: Jennifer
authors.initials: J
authors.lastname: Alvarez
authors.forename: Joanne
authors.initials: J
authors.lastname: Pavao
authors.forename: Katelyn P
authors.initials: KP
authors.lastname: Mack
authors.forename: Joan M
authors.initials: JM
authors.lastname: Chow
authors.forename: Nikki
authors.initials: N
authors.lastname: Baumrind
authors.forename: Rachel
authors.initials: R
authors.lastname: Kimerling
mesh_terms: D000293:Adolescent; D000328:Adult; D018585:Battered Women / Q000523:psychology* / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000472:pathogenicity; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D017579:Domestic Violence / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D011159:Population Surveillance; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology; D016387:Women's Health; D055815:Young Adult