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Background: Chlamydia is the most commonly reportable bacterial STD in the United States. Repeated infections may be associated with worse health outcomes including increased susceptibility to HIV. For over a decade, Mississippi reported among the highest rate of chlamydia. The purpose of this study is to describe the epidemiology of chlamydia infections and identify risk factors associated with multiple infections.
Methods: Demographic data was reviewed from chlamydia cases reported to the Mississippi State Department of Health’s STD Management Information System from January 1, 2005, through December 31, 2012. Characteristics of individuals with one chlamydia infection were compared to individuals with repeat infections. Further analyses were performed to assess risk factors associated with recent repeat chlamydia infections (more than one infection between 1 and 6 months).
Results: During 2005-2012, Mississippi reported 172,030 chlamydia episodes (96,567 single cases and 30,011 repeat infections). Among repeat infections, 9,076 or 30.2% were recent repeat infections. The mean age of individuals with chlamydia infection was 22 ± 6.4 years, with 76% of cases among individuals under 25 years old. The number of repeat infections reported ranged from 2-13 per individual (mean = 2.5 + 0.9 cases) and the mean time between first and second repeat infection was 19 months ± 17 months. In the multivariate analysis, the factors associated with recent repeat infections included younger age, African American race, and female gender.
Conclusions: Our analysis shows that recent repeat chlamydia infections are associated with younger age, individuals who are African American, and female. Improved strategies are needed to address all potential factors contributing to repeat chlamydial infections including appropriate treatment of infected patients, partner’s treatment, routine re-screening. Public health programs may use this data to target populations and areas with the highest proportion of recent repeat infections for more intense counseling of infected patients and re-screening programs.