Reported Chlamydia and Gonorrhea Are Decreasing Among Young Black Women: Good News or Bad News? A Narrative Review

Abstract

Since 2010, reported chlamydia and gonorrhea rates decreased From the

Changes in Sexual Behaviors with Opposite-Sex Partners and Sexually Transmitted Infection Outcomes Among Females and Males Ages 15–44 Years in the USA: National Survey of Family Growth, 2008–2019

“…By comparison, national laboratory testing data indicated that gonorrhea and chlamydia test positivity decreased from 2010 to 2017 among 12–17-year-old females but increased among women ages 18–30 and pregnant persons (Kaufman et al, 2020 ; Niles et al, 2021 ). Among National Job Training Program participants ages 16–24, gonorrhea prevalence increased among females and decreased among males from 2011 to 2017 (Learner et al, 2020 ), and chlamydia prevalence increased among 20–24-year-old White women, decreased among 20–24-year-old Black men from 2010 to 2017, and remained stable among other groups (Diesel et al, 2021a , 2021b ). Each dataset has important limitations that may contribute to the differences in findings.…”

“…With respect to testing behaviors, however, national health systems data suggested that chlamydia testing coverage increased among adolescent girls and young women from the mid-2000s to early 2010s (Hsieh et al, 2017;Tao et al, 2018). Additionally, evidence from national laboratory data and a sentinel surveillance program found that trends in chlamydia and gonorrhea positivity from 2010 to 2017 varied by age, sex, and race/ethnicity but did not reflect the increases in reported diagnoses (Diesel et al, 2021(Diesel et al, , 2021bKaufman et al, 2020;Learner et al, 2020;Niles et al, 2021;U.S. Preventive Services Task Force et al, 2021).…”

“…With respect to testing behaviors, however, national health systems data suggested that chlamydia testing coverage increased among adolescent girls and young women from the mid-2000s to early 2010s (Hsieh et al, 2017 ; Tao et al, 2018 ). Additionally, evidence from national laboratory data and a sentinel surveillance program found that trends in chlamydia and gonorrhea positivity from 2010 to 2017 varied by age, sex, and race/ethnicity but did not reflect the increases in reported diagnoses (Diesel et al, 2021 , 2021b ; Kaufman et al, 2020 ; Learner et al, 2020 ; Niles et al, 2021 ; U.S. Preventive Services Task Force et al, 2021 ). However, except Ueda et al ( 2020 ), these analyses of sexual behavior did not cover the more recent period from 2015 to 2019 during which gonorrhea in particular has been rising rapidly (Centers for Disease Control & Prevention, 2021 ), and most are missing behaviors such as frequency of sex or sexual network attributes, defined as the behaviors and partnership-level characteristics that contribute to linkages among people in sexual networks (Doherty et al, 2005 ; Weiss et al, 2020 ).…”

Developing Sentinel Surveillance for Chlamydia and Gonorrhea Using Test Results From Routine Screening During Pregnancy

“…8 It is difficult to determine why reported number of persons testing positive may be decreasing in some groups and not others. 9 Ronn et al 10 hypothesized that increased screening and partner notification practices in 2000-2015 may account for the observed downward trend in chlamydia prevalence in NHANES. A 2021 comparison of reported cases and prevalence in the National Job Training Program suggested that changes in the number of persons testing positive could be due to changes in screening practices rather than changes in the prevalence of infection.…”

“…Another analysis of approximately 390,000 women between the ages of 16 and 24 years who were enrolled in the National Job Training Program demonstrated a decline in the percentage of persons testing positive for chlamydia from 1990 to 2002 and a stabilization of chlamydia cases from 2002 to 2012 8 . It is difficult to determine why reported number of persons testing positive may be decreasing in some groups and not others 9 . Ronn et al 10 hypothesized that increased screening and partner notification practices in 2000–2015 may account for the observed downward trend in chlamydia prevalence in NHANES.…”