Yale Bulletin and Calendar

April 20, 2007|Volume 35, Number 26

Yale researchers urge education to halt
high rate of recurring chlamydia infections

Recurring chlamydia infections are prevalent in young women ages 14-19, according to a Department of Epidemiology and Public Health study published by Linda Niccolai, assistant professor in the division of Epidemiology of Microbial Diseases, in the Archives of Pediatrics and Adolescent Medicine.

Chlamydia is one of the most common sexually transmitted diseases in men and women. It is caused by a bacterial infection, Chlamydia trachomatis. The disease often has no symptoms and can seriously damage a woman's reproductive organs. Long-term health consequences include pelvic inflammatory disease, chronic pelvic pain and infertility. Even if an infected woman has been treated, she can become re-infected if her partner has not been treated.

The Yale study was conducted at 10 community-based health centers in Connecticut. The women were examined at their initial visit and after 6, 12 and 18 months. A total of 386 women were evaluated long-term.

More than half of the study's 411 participants were initially diagnosed with chlamydia and then, in a rate higher than previously recorded, nearly 30% reported repeated infection throughout the four-year project.

Niccolai says there are many reasons why young women are getting infected and re-infected at such a high rate. One may be that the young women's sex partners are not being adequately treated for their first infection, she notes.

"Women are much more likely than men to be diagnosed simply because they are more likely to seek reproductive health care," says Niccolai. "Then they shoulder the burden to notify their partners about the infections and ensure their partner gets treated, which can be a very difficult thing for a young woman to do in the context of a sexual relationship."

Niccolai states that a major reason for chlamydia infection and re-infection is the lack of consistent and correct use of condoms, which may result from the misperception of risk in relationships. Multiple sex partners, she says, also might be partly responsible for the higher rates of re-infection.

To prevent re-infection, Niccolai notes, it is important at the time of the initial diagnosis to educate and counsel patients. "It is possible that young women think chlamydia is 'no big deal' because it is easily treated with a single dose of oral antibiotics," she says. Providing condom negotiation skills also is important, as well as how best to ensure that sex partners get treated, Niccolai says.

Co-authors include Abby Hochberg, Kathleen Ethier, Jessica Lewis and Jeannette Ickovics.

-- By Jacqueline Weaver

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