The Curious Case of Rates of Gonorrhea and Chlamydia Among Adolescents (15-19 years) in the United States, 2011-2015

Background: Chlamydia and gonorrhea disproportionately affect adolescents and young adults. To describe burden of disease and inform prevention and control activities, we investigated trends in rates of reported cases among adolescents.  

Methods:  We examined national chlamydia and gonorrhea case report data for 2011–2015 to assess rates of chlamydia and gonorrhea among adolescents aged 15–19 years by sex, region, and diagnosing facility type. Data from 2015 are preliminary and include cases reported to CDC as of March 3, 2016.

Results:  In 2015, 379,496 chlamydia cases and 69,440 gonorrhea cases were reported among adolescents, accounting for 25.6% and 18.1% of all reported chlamydia and gonorrhea cases, respectively. During 2011–2015, rates of chlamydia and gonorrhea declined among adolescent females; chlamydia: 3,485.2 to 2,905.6 cases per 100,000 population and gonorrhea: 567.7 to 426.8 cases per 100,000. However, among adolescent males, rates declined during 2011–2014 (chlamydia: 816.3 to 722.4 cases per 100,000 and gonorrhea: 252.7 to 222.2 cases per 100,000) and then increased during 2014–2015 (chlamydia increased 2.8% to 742.6 cases per 100,000 and gonorrhea increased 6.2% to 235.9 cases per 100,000). Rates of gonorrhea among adolescent males increased in all regions during 2014–2015. Strikingly, the gonorrhea rate among adolescent males in the West increased annually 10.6% and 48% overall during 2011–2015 (109.5 to 162.1 cases per 100,000). During 2011–2015, the proportion of adolescent male cases diagnosed in STD clinics declined from 18.2% to 11.7% while the proportion diagnosed in private settings remained unchanged and proportion with unknown facility type increased.

Conclusions:  After years of decreases, preliminary 2015 data indicate chlamydia and gonorrhea rates are increasing among adolescent males while rates continue to decline among adolescent females. A better understanding of where adolescents seek STI testing and treatment may help inform prevention services for this vulnerable population.