Comparative Behavioral Epidemiology of Gonococcal and Chlamydial Infections among Patients Attending a Baltimore Maryland, Sexually Transmitted Disease Clinic

Abstract

Between April 1988 and May 1989, 400 males and 400 females attending a Baltimore, Maryland, sexually transmitted disease clinic were enrolled in a study evaluating and comparing behaviors associated with culture-proven gonococcal or chlamydial infection. The subjects were enrolled consecutively, and were all seen by the same clinician. Among participants of each sex, gonorrhea but not chlamydia was associated with increasing numbers of recent (the past 30 days) sexual partners. Compared with males with neither infection, factors independently associated with increased risk of gonorrhea included age less than 20 years (odds ratio (OR) = 1.93), the presence of genitourinary symptoms (OR = 8.07), and recent exposure to a new sexual partner (OR = 2.78); risk for chlamydial infection in males was associated with genitourinary symptoms (OR = 2.83) and was significantly reduced in those reporting multiple recent (OR = 0.19) or new (OR = 0.07) sexual partners. Among females, age less than 20 years was independently associated with gonococcal (OR = 1.86) and chlamydial (OR = 7.79) infections in comparison with females with neither infection. No other behavioral factors were associated with chlamydial infection for females in this study; however, having a regular sexual partner was associated with significantly elevated risk of gonorrhea (OR = 3.85), while the presence of genital tract symptoms was associated with diminished risk (OR = 0.29) for gonorrhea. These data suggest that there are differences in the behaviors associated with gonorrheal and chlamydial infections and that different strategies may be useful in efforts to control these infections.

The Prevalence of Chlamydia, Gonorrhea, and Trichomonas in Sexual Partnerships: Implications for Partner Notification and Treatment

“…Consistent with other studies, 25,26,30 our results demonstrate that dyad members have a high likelihood of similar STD, thus providing a significant opportunity for PDPT to reduce the risk of reinfection and transmission.…”

“…Thus, empiric treatment of partners before availability of test results is a feasible and cost-effective strategy in reducing repeated infections. 2,17,29,30 Based on our results, we estimated that PDPT for chlamydia only or gonorrhea-chlamydia coinfection, depending on the index subject's diagnosed infection, would effectively treat 57% (41 of 72) of partners of CT-only index subjects and 57%(20 of 35) of the partners of GC or GC-CT-coinfected index subjects.…”

From Slavery to Incarceration: Social Forces Affecting the Epidemiology of Sexually Transmitted Diseases in the Rural South

“…10 In 3 studies of urban STD clinic populations, each using a different period of recall, the proportions of men reporting they had multiple sex partners during periods of 1 month, 6 months, and 1 year were 42%, 56%, and 82%, respectively. For women, the respective proportions were 15%, 34%, and 76%.…”

Risk factors for genital chlamydial infection

“…First, the time frame of the question may bias the observed relationships. Because of the high proportion of asymptomatic cases and the relatively long incubation period for symptomatic cases (seven to 21 days) (84,85), cases that are detected are less likely to be newly acquired (25,55,61,78). Therefore, reporting new or casual partners in the past one to three months may be a less relevant risk behaviour because the most recent partner(s) may not be the source of the infection.…”

“…It is possible that men overreport the number of sexual partners while women underreport in effort to provide more socially desirable responses (86). As well, the classification of a sexual relationship by its partners may be discordant (78). Differential misclassification may over-or underestimate the association between the exposure and outcome.…”