Comprehensive assessment of sociodemographic and behavioral risk factors for Mycoplasma genitalium infection in women.
BACKGROUND
Neisseria gonorrhoeae and Chlamydia trachomatis are characterized by different risk factors, thus control strategies for each also differ. In contrast, risk factors for Mycoplasma genitalium have not been well characterized.


METHODS
Between 2000 and 2006, 1090 women ages 14 to 45 attending the Public Health-Seattle & King County Sexually Transmitted Diseases Clinic in Seattle, WA, underwent clinical examination and computer-assisted survey interview. M. genitalium was detected by transcription mediated amplification from self-obtained vaginal swab specimens. C. trachomatis and N. gonorrhoeae were detected by culture from cervical swab specimens.


RESULTS
Prevalent M. genitalium infection was detected in 84 women (7.7%), C. trachomatis in 63 (5.8%), and N. gonorrhoeae in 26 (2.4%). Age <20 and nonwhite race were associated with increased risk for all 3 organisms. In addition, risk for M. genitalium was higher for women with a black partner (adjusted odds ratio [AOR]: 3.4; 95% confidence interval = 1.83-6.29), those never married (AOR: 2.6; 1.08-6.25), using Depo-Provera (AOR: 2.3; 1.19-4.46), and smoking (AOR: 1.7; 1.03-2.83). Drug use, history of STI in the past year, ≤high school education, meeting and having intercourse the same day, anal sex, douching, and hormonal contraception were associated with N. gonorrhoeae or C. trachomatis, but not with M. genitalium. Number of partners was not associated with any of the 3 organisms.


CONCLUSIONS
The limited number of risk factors for prevalent infection common to all 3 pathogens suggests that M. genitalium may circulate in different sexual networks than N. gonorrhoeae or C. trachomatis. The predominance of sociodemographic risk factors for M. genitalium, rather than high-risk sexual behaviors, suggests broad-based testing may be the most effective control strategy.
Hancock
Emily B
EB
Department of Epidemiology, University of Washington, Seattle, WA, USA.
Manhart
Lisa E
LE
Nelson
Sara J
SJ
Kerani
Roxanne
R
Wroblewski
Jennifer K H
JK
Totten
Patricia A
PA
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000382:microbiology; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology; D006306:Health Surveys / Q000379:methods; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009175:Mycoplasma Infections / Q000175:diagnosis* / Q000453:epidemiology; D045704:Mycoplasma genitalium; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D014861:Washington; D055815:Young Adult