Generation C: prevalence of and risk factors for chlamydia trachomatis among adolescents and young women in Lima, Peru.
OBJECTIVE
Adolescent and young adult women in urban, socioeconomically disadvantaged areas are at high risk of contracting sexually transmitted infections (STIs). We assessed associations of Chlamydia trachomatis (CT) infection with both traditional STI risk factors, and partner and partnership-related factors among low-income women in Lima, Peru, by age group.


METHODS
In a cross-sectional analysis of CT infection among 1290 postpartum women, cervical swabs were collected for CT polymerase chain reaction (PCR) within 48 h after delivery, and a structured interview was completed. Multivariate logistic regression was used to evaluate risk factors for CT, with separate models stratified by age: adolescents (12-19 years), young women (20-24 years), and older women (>or=25 years).


RESULTS
CT was detected in 9.6% of adolescents, 9.0% of young women, and 5.4% of older women (p = 0.03). Among adolescents, history of drug use (odds ratio [OR] = 5.62, 95% confidence interval [CI] 1.03-30.6) and short duration of current partnership (OR = 2.6, 95% CI 1.14-5.93) were the strongest predictors of CT infection. Among young women, younger age at coitarche (OR = 0.74 for each year older, 95% CI 0.60-0.91) and low income (OR = 2.40, 95% CI 1.04-5.55) were associated with CT, while self-report of ever using condoms was protective (OR = 0.22, 95% CI 0.08-0.61). Among older women, only younger age at coitarche was related to CT (OR = 0.85, 95% CI 0.75-0.97).


CONCLUSIONS
Risk factors for CT among women in Lima, Peru, differed for adolescents, young women, and older women, which may reflect differences in biology and/or immunology of CT as well as variability in the occurrence of specific risk behaviors by age group.
Paul
Kathleen J
KJ
Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington 98195, USA. ktpaul@u.washington.edu
Garcia
Pedro J
PJ
Giesel
Ann E
AE
Holmes
King K
KK
Hitti
Jane E
JE
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D017677:Age Distribution; D002690:Chlamydia Infections / Q000453:epidemiology*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016017:Odds Ratio; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D016387:Women's Health; D055815:Young Adult
Reprod Health Matters. 2001 May;9(17):170-83
11468834
Am J Obstet Gynecol. 2000 Sep;183(3):662-8
10992190
JAMA. 1996 Dec 4;276(21):1737-42
8940322
AIDS. 2003 Mar 7;17(4):613-8
12598782
Pediatrics. 1984 Jun;73(6):836-40
6547226
Int J Gynaecol Obstet. 1997 Jul;58(1):107-19
9253673
Lancet. 2007 Apr 7;369(9568):1220-31
17416266
Am J Public Health. 1996 Aug;86(8):1098-107
8712268
ABNF J. 2005 May-Jun;16(3):52-5
16092734
Sex Transm Infect. 1999 Feb;75(1):3-17
10448335
Sex Transm Dis. 1992 Mar-Apr;19(2):61-77
1595015
JAMA. 1986 Oct 10;256(14):1899-903
3761496
AIDS. 2003 Mar 7;17(4):605-12
12598781
Am J Obstet Gynecol. 1985 Oct 1;153(3):244-51
4050890
J Biosoc Sci. 2005 Jan;37(1):1-36
15688569
J Fam Plann Reprod Health Care. 2006 Apr;32(2):104-6
16824301
Sex Transm Infect. 1998 Jun;74 Suppl 1:S12-6
10023347
JAMA. 1998 Jul 1;280(1):49-54
9660363