Chlamydia Among Women Attending Louisiana Infertility Prevention Project Family Planning Clinics: Project Positivity, Socioeconomic Position, and STD Case Reports

Background: Louisiana (LA) Infertility Prevention Project (IPP) supports screening and treatment of chlamydia for women and their male partners in family planning (FP) clinics. The STD program surveillance system monitors all reported LA chlamydia cases.     

Objectives: Assess chlamydia positivity (CT+) by individual, areal socioeconomic position (SEP), and case rate measures for women aged < 30 years at LA IPP FP clinics, 2007.     

Methods: CT+ was calculated by demographics, areal SEP and racial measures, and parish chlamydia rates for 31,707 tests from FP clinics, 2007. Areal measures were generated from Census and state files. Surveillance records were aggregated to parishes. Files were matched to IPP records via client ZIP and parish FIPS. Univariate and multivariate analyses (MVA) performed.

Results: 29% were female clients aged <20 years; 42% were white, 55% black, 3% Hispanic. 58% resided in cities. CT+ was 7.0%, ranging from 10.3% (blacks) to 3.0% (whites). Adolescent CT+=10.5% and fell to 3.8% for women aged 25-29. 44% lived in areas with ≥20% population below 100% federal poverty level (FPL). 28% came from parishes with <20% black population; 11% from parishes with ≥50% blacks. CT+ was associated with areal poverty: 0-19% FPL: 6.2% CT+ versus ≥20% FPL: 8.0%. Percent black population was associated with CT+, <20% black: 5.1%; ≥50% black: 10.7% CT+. Urban and rural areas had comparable CT+ (7.4% vs. 6.7%). Female parish case rate quintiles were associated with CT+, lowest female case rate quintile: 4.6% IPP CT+; highest quintile: 8.9% CT+.

Conclusions: Chlamydia was associated with areal demographics more than SEP. LA IPP accesses a large rural population with significant CT+. FP IPP female CT+ increases with areal female case rates, but not male rates.

Implications for Programs, Policy, and/or Research: Areal racial minority Census indicators and local female case rates may be useful for FP clinic client in-reach and outreach to target higher risk populations.