Predictors of repeat Chlamydia trachomatis infections diagnosed by DNA amplification testing among inner city females

Objective: To describe the epidemiology of prevalent and incident chlamydia infection in order to assess the appropriate interval for chlamydia screening; and to identify risk factors predictive of infection and repeat infections. Design: Prospective longitudinal study of a consecutive sample of 3860 sexually active females aged 12-60 years tested for C trachomatis by polymerase chain reaction in Baltimore City clinics during 11, 904 patient visits over a 33 month period. Results: Chlamydia prevalence, incidence, and frequency to diagnosis of infection varied by age. Among 2073 females <25 years, chlamydia infection was found in 31.2%. The median times to first and repeat incident infections were 7.0 months and 7.6 months, respectively. Among 1787 females ≥25 years, chlamydia infection was found in 9.6%. Median times to first and repeat incident infections were 13.8 months and 11.0 months, respectively. Age <25 years yielded the highest risk of infection. Conclusions: Since a high burden of chlamydia was found among mostly asymptomatic females <25 years in a spectrum of clinical settings, we recommend chlamydia screening for all sexually active females <25 years at least twice yearly.