Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 37, Number 3, September 2005

Gonorrhea and Chlamydia Infection Among Women Visiting Family Planning Clinics: Racial Variation in Prevalence and Predictors

By Lisa A. Einwalter, Justine M. Ritchie, Kevin A. Ault and Elaine M. Smith

CONTEXT: Black women are disproportionately infected with gonorrhea and chlamydia. Because of the potential impact of these infections on women's reproductive health, it is important to determine whether different factors are predictive of infection in women of different races.

METHODS: Data from 31,762 women aged 15–24 who were tested for gonorrhea and chlamydia at Missouri family planning clinics in 2001 were used to calculate the prevalence of each infection by selected variables. Logistic regression analysis was used to assess factors associated with the risk of infection.

RESULTS: Overall, 0.7% of women had gonorrhea, and 4% had chlamydia. The gonorrhea rate was 4% for blacks and 0.4% for whites; the chlamydia rate, 9% and 4%, respectively. Independent predictors of gonorrhea in both races were symptoms, recent sexual contact with a partner who had STD symptoms, and chlamydia infection. Predictors specific to whites were visiting the clinic for STD care and having a new partner or multiple partners in the past year. Being aged 15–21 was associated with an elevated risk of gonorrhea for blacks only. In both racial groups, chlamydia infection was associated with younger age, contact with a symptomatic partner, cervicitis, cervical friability and gonorrhea positivity. Additional predictors among whites were having a new partner, having multiple partners and having pelvic inflammatory disease; no other factors were significant for blacks.

CONCLUSIONS: The prevalence and predictors of gonorrhea and chlamydia infection differ significantly between blacks and whites. Until these disparities are better understood, it will be difficult to establish screening criteria for gonorrhea.

Perspectives on Sexual and Reproductive Health, 2005, 37(3):135–140

DOI:10.1363/3713505







 

 
 

Lisa A. Einwalter is a medical student; Justine M. Ritchie is a biostatistician and adjunct assistant professor, Department of Biostatistics—both at the University of Iowa College of Public Health, Iowa City. Kevin A. Ault is associate professor of obstetrics and gynecology, and associate professor of epidemiology; Elaine M. Smith is professor of epidemiology and of obstetrics and gynecology—both at the University of Iowa Hospitals and Clinics, Iowa City.