Chlamydia and Gonorrhea Trends Among Women Aged 15-24 Years Attending Region VI Infertility Prevention Project Family Planning and STD Clinics, 1996 - 2007

Background:
Since 1996, the Region VI Infertility Prevention Project (IPP) has provided screening and treatment for chlamydia (CT) and gonorrhea (GC) to women attending family planning (FP) and STD clinics in southwestern U.S.

Objective:
1) Assess region-wide trends in CT and GC among women aged 15-24 years attending FP and STD clinics, 1997-2006; 2) explore age and race/ethnic differences in CT/GC prevalence.

Method:
Annual CT positivity was calculated by age, race/ethnicity and clinic type (FP/STD) for over 1,300,000 CT/GC tests in Region VI FP and STD clinics, 1996-2007.

Result:
FP clinics accounted for 80% of the 1,300,000 CT/GC tests performed in Region VI FP/STD clinics, 1996-2007, among women aged 15-24 years. Comparing 1996 and 2007, FP CT+ was stable (7.8%, 8.1%); STD CT+ trended higher (14.3%, 16.2%). 1996 and 2007 FP CT+ was stable for NH Whites (1996: 5.4%, 2007: 5.0%) and increased for NH Blacks (1996: 11.2%, 2007: 14.0%). In STD clinics, CT+ increased (1996: 14.3%; 2007: 16.2%). Increases were seen for all sub-groups: 15-19 (1996: 17.8%; 2007: 19.2%); 20-24 (10.4%, 14.3%); NH Whites (12.1%, 13.6%); and, NH Blacks (15.4%, 18.1%). Comparing 1996 and 2007, FP GC+ was low and stable (1.4%, 1.6%). Highest GC+ 1996-2007 was in NH Blacks aged 15-19 (4.9%, 6.2%). For 1996 and 2007, STD clinic GC+ trended lower (10.8%, 7.1%). STD clinic GC+ for all sub-groups fell over time.

Conclusion:
CT+ and GC+ varied by clinic type, age and race/ethnicity. FP CT+ was stable, except for increases among NH Blacks. STD clinics had CT/GC positivities 2-10 times comparable FP demographic groups. STD clinic GC+ trended lower 1996-2007.

Implications:
Demographic differences on CT/GC were enduring and widespread. Eliminating age and racial/ethnic differences will require enhanced efforts at preventing infections, monitoring interventions, and delivering care to these groups. Future work should explore additional client, clinic and community factors.