2006 STD Prevention Conference – Day 2 Press Release, May 9, 2006

Data from the National STD Prevention Conference Underscore Severe Impact of Chlamydia and Improved Strategies to Combat the Disease; Emerging Data on Risk Behaviors among Youth Also Presented

• New data indicate high levels of repeat chlamydia infection among young women and high prevalence among college freshmen
• Innovative screening and treatment efforts significantly reduce prevalence
• Researchers report data documenting increases in oral and anal sex among youth

Jacksonville, Fla. (May 9) – New data presented today at the 2006 National STD Prevention Conference reveal higher-than-expected rates of repeat chlamydia infection among young women, as well as a high prevalence of the disease among college freshmen. But other findings presented at the conference demonstrate that innovative chlamydia screening efforts, including screening in public high schools and jails, can have a significant impact on chlamydia prevalence in affected communities.

It is estimated that as many as 2.8 million cases of chlamydia occur every year in the United States. Left untreated, the disease, which often has no symptoms, can lead to serious health problems, including pelvic inflammatory disease, which can in turn lead to infertility and ectopic pregnancy. In addition, women infected with chlamydia are up to five times more likely to become infected with HIV.

Additional research from Baltimore, released at the conference, documents increases in oral and anal sex among young people – behaviors that place them at risk for STDs.

Repeat chlamydia infections underscore need for improved partner notification and treatment

New data reported by the New York City Department of Health and Mental Hygiene show that one in eight women diagnosed with chlamydia citywide in recent years had a repeat infection within one year of their initial diagnosis; nearly a third of repeat infections occurred within just three months. The research, the first citywide study to measure the extent of repeat chlamydia infection, also found that the re-infection rate for adolescent women (ages 10-19) was roughly twice that seen in women ages 25 to 29 (Oral 5). Similar findings were seen in an analysis by the California Department of Health Services, which showed that at least one in 10 women tested for chlamydia through the state family planning program and at a large health maintenance organization were infected again within six months, with adolescent women most affected (Poster 119). These findings suggest that many women are being re-infected by sexual partners who have not been diagnosed and treated for the disease.

According to CDC, the studies reinforce the need for comprehensive STD prevention and treatment services for young people, including not only chlamydia screening for all sexually active women under the age of 26, but also continued follow-up for infected women and their sexual partners.

“These new data show that we need to improve efforts to keep young women chlamydia-free after they receive initial treatment,” said Dr. John M. Douglas, Jr., Director of the Division of STD Prevention at CDC’s National Center for HIV, STD and TB Prevention (NCHSTP). “That means providing education on risk reduction, ensuring that women’s sexual partners are diagnosed and treated for chlamydia, implementing innovative approaches such as providing women with medicine that they can take directly to their partners, and providing routine re-screening of women after treatment to permit earlier detection and treatment of re-infection.”

Other research, from the Emory University School of Medicine, showed that college freshmen may be at particularly high risk for infection. The study of nearly 800 students at 10 southeastern U.S. colleges found that nearly 10 percent of students overall were infected with chlamydia. When the data were analyzed by class, freshmen were nearly 70 percent more likely than upperclassmen to be infected. Findings point to the importance of student health centers providing chlamydia screening and treatment services and educating incoming students about STD risks and prevention strategies (Poster 90).

Intensive chlamydia programs in schools, jails, and on the Internet prove successful

The implementation of intensive, citywide chlamydia screening efforts in Philadelphia led to a 24 percent decline in disease prevalence among high school students tested over the program’s first three years, according to researchers from the Philadelphia Department of Public Health. Launched in 2002, the program provides routine chlamydia and gonorrhea screening in all public high schools, and in other facilities that reach individuals at risk, such as public health clinics and correctional facilities. In addition to the declines in prevalence among students, researchers found that the total number of reported chlamydia cases citywide fell 14 percent from 2003 to 2005, suggesting that intensive screening programs may lead to reductions of infection in the larger community (Oral 339, Poster 99).

In San Francisco, a routine chlamydia and gonorrhea screening program at the county jail was associated with substantial reductions in the prevalence of the disease in the surrounding community. Supported by the Department of Public Health, the San Francisco County Jail began providing routine screening and treatment in 1996, testing and treating more than 40,000 adults (ages 18-35) between 1997 and 2004. To measure the impact of the program on the overall chlamydia burden in surrounding communities, researchers examined trends in chlamydia prevalence among young women ages 15 to 25, the population most frequently screened and most heavily affected by the disease. In one neighborhood, where an estimated 324 in every 1,000 adult residents had been screened in jail, the prevalence of chlamydia fell by nearly half among young women tested from 1997 to 2004. In comparison, prevalence fell only 6 percent among young women tested in a neighborhood where only eight in 1,000 adult residents had been screened in jail (Oral 343).

“These innovative programs show what can be accomplished with an intensive and sustained commitment to chlamydia screening, treatment and prevention,” said Dr. Ronald O. Valdiserri, Deputy Director of NCHSTP. “They should serve as models to be studied and adapted by cities across the country to help reduce the impact of chlamydia and protect women from infertility and other serious, but preventable, health problems.”

In another study, researchers from Johns Hopkins University reported that a new Internet-based chlamydia screening program is successfully reaching women at risk for the disease. The program allows women to collect vaginal swabs in their own homes and return them to a lab through the mail. Among 567 women tested in the program from July 2004 to December 2005, 9 percent tested positive for chlamydia. Women reported high rates of sexual risk behaviors, suggesting that the program is reaching women who are in need of STD testing and prevention services (Oral 1, Poster 142).

Baltimore STD clinic study shows doubling of oral, anal sex in young people

A study, also from Johns Hopkins University, found a significant increase in oral and anal sexual intercourse reported by young people ages 12 to 25 attending Baltimore STD clinics over the past decade. Examining medical records of adolescent patients in 1994 and 2004, researchers found that the prevalence of self-reported oral sex in approximately the previous 90 days doubled among young males (from 16% to 32%) and more than doubled among young females (from 14% to 38%) over the 10-year period. Among young women, the prevalence of self-reported anal sex – though uncommon – nearly doubled over the period (from 3% to 5.5%). Public health officials stress the need to educate young people about the significant STD transmission risks posed by these behaviors (Oral 17).