title: Gender-based screening for chlamydial infection and divergent infection trends in men and women.
abstract: OBJECTIVE
  To assess the potential impact of chlamydial screening policy that recommends routine screening of women but not men.
  
  
  METHODS
  Population surveys of probability samples of Baltimore adults aged 18 to 35 years in 1997-1998 and 2006-2009 collected biospecimens to estimate trends in undiagnosed chlamydial infection. Survey estimates are compared to surveillance data on diagnosed chlamydial infections reported to the Health Department.
  
  
  RESULTS
  Prevalence of undiagnosed chlamydial infection among men increased from 1.6% to 4.0%, but it declined from 4.3% to 3.1% among women (p = 0.028 for test of interaction). The annual (average) number of diagnosed infections was substantially higher among women than men in both time periods and increased among both men and women. Undiagnosed infection prevalence was substantially higher among black than non-black adults (4.0% vs 1.2%, p = 0.042 in 1997-98 and 5.5% vs 0.7%, p<0.001 in 2006-09).
  
  
  CONCLUSIONS
  Divergent trends in undiagnosed chlamydial infection by gender parallel divergent screening recommendations that encourage chlamydial testing for women but not for men.
authors.affiliation: Statistics and Epidemiology Division, Research Triangle Institute, Washington D.C., United States of America.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Rogers
authors.affiliation: Queens College and the Graduate Center, City University of New York, Flushing, New York, United States of America.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Turner
authors.affiliation: School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America.
authors.forename: William C
authors.initials: WC
authors.lastname: Miller
authors.affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Emily
authors.initials: E
authors.lastname: Erbelding
authors.affiliation: Statistics and Epidemiology Division, Research Triangle Institute, Washington D.C., United States of America.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Eggleston
authors.affiliation: Statistics and Epidemiology Division, Research Triangle Institute, Washington D.C., United States of America.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Tan
authors.affiliation: Center for Survey Research, University of Massachusetts at Boston, Boston, Massachusetts, United States of America.
authors.forename: Anthony
authors.initials: A
authors.lastname: Roman
authors.affiliation: School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America.
authors.forename: Marcia
authors.initials: M
authors.lastname: Hobbs
authors.affiliation: Statistics and Epidemiology Division, Research Triangle Institute, Research Triangle Park, North Carolina, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Chromy
authors.affiliation: Baltimore City Department of Health, Bureau of STI/HIV Prevention, Baltimore, Maryland, United States of America.
authors.forename: Ravikiran
authors.initials: R
authors.lastname: Muvva
authors.affiliation: Research Computing Division, Research Triangle Institute, Research Triangle Park, North Carolina, United States of America.
authors.forename: Laxminarayana
authors.initials: L
authors.lastname: Ganapathi
mesh_terms: D000293:Adolescent; D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology*; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000639:trends; D015995:Prevalence; D012737:Sex Factors; D055815:Young Adult