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Background: Chlamydia ranks as the number one reported communicable disease in New York State (NYS) and nationally. Chlamydia trachomatis infection is one of the leading causes of infertility among women of childbearing age, and repeat infections are associated with an increased risk for long term sequelae.
Objectives: To assess the frequency and predictors of Chlamydia re-infection among women in NYS.
Methods: A retrospective cohort of women 10-44 years of age with an initial Chlamydia diagnosis between January 1, 2006 and December 31, 2010 was identified using NYS surveillance data. A re-infection was defined as an additional infection, reported a minimum of 22 days after an appropriately treated initial infection. Descriptive analysis, relative risks (RR) and 95% confidence intervals (CI) were calculated using SAS v 9.1.3.
Results: A total of 113,734 case reports, accounting for 88,972 individual women, met the study criteria. Of these individuals, 73,338 had a single infection, 11,311 developed one re-infection and 4,323 developed two or more re-infections (range 2 to 12). Risk of re-infection was greatest for women 20 years of age or younger (RR = 2.0, 95% CI: 2.0, 2.1), black, non-Hispanic women (RR=1.8, CI: 1.7, 1.8), and women coinfected with gonorrhea (RR=1.6, CI: 1.5, 1.7).
Conclusions: This study found that 18% of women became re-infected during the study period which is similar to literature reports indicating that between 15-24% of women become re-infected. These data underscore recommendations issued by the CDC which promote re-testing all infected women and men three months after initial Chlamydia infection.
Implications for Programs, Policy, and Research: The results are intended to assist STD programs in developing targeted Chlamydia prevention and partner services activities.