This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A. Eugene Washington, MD, MSc; Sevgi O. Aral, PhD; Pål Wølner-Hanseen, MD, DMS; David A. Grimes, MD; King K. Holmes, MD, PhD

JAMA. 1991;266(18):2581-2586.

Abstract
To assess the risk for pelvic inflammatory disease (PID), a practitioner must evaluate the likelihood that a woman has PID or will be exposed to a sexually transmitted disease causing PID. Successful risk assessment depends on accurate information about variables influencing risk of PID. To determine the current state of knowledge about PID risk variables, we examined data in published reports. Data on each risk variable were scrutinized to discern which link(s) in the PID risk chain it affects (acquisition of a sexually transmitted disease, development of PID, or development of PID sequelae) and whether it is a risk marker or a risk factor. Most PID risk variables, particularly sexual behaviors, are associated with acquisition of a sexually transmitted disease, rather than development of PID itself. With the exception of age, demographic and social indicators of risk appear to be risk markers, while contraceptive practices appear more often to be risk factors than risk markers. Additional data are needed for most PID risk variables confidently to categorize them as risk factors. Enough information is available, however, to begin assessing risk for PID, so that appropriate counseling can ensue and timely diagnosis can be made.

(JAMA. 1991;266:2581-2586)

Author Affiliations
From the Center for Reproductive Health Policy Research, University of California School of Medicine, San Francisco (Dr Washington); Division of STD/HIV Prevention, Centers for Disease Control, Atlanta, Ga (Dr Aral); Department of Obstetrics and Gynecology, University of Lund, Sweden (Dr Wølner-Hanssen); Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles (Dr Grimes); and the Center for AIDS and STD, University of Washington, Seattle (Dr Holmes).

Footnotes
Reprint requests to Center for Reproductive Health Policy Research, University of California School of Medicine, 1388 Sutter St, 11th Floor, San Francisco, CA 94143 (Dr Washington).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Risk factors associated with pelvic inflammatory disease
Simms et al.
Sex. Transm. Infect. 2006;82:452-457.
ABSTRACT | FULL TEXT  

Copper IUDs, infection and infertility
DTB 2002;40:67-69.
ABSTRACT | FULL TEXT  

Assessment of risk for pelvic inflammatory disease in an urban sexual health population
Marks et al.
Sex. Transm. Infect. 2000;76:470-473.
ABSTRACT | FULL TEXT  

Pelvic inflammatory disease epidemiology: what do we know and what do we need to know?
Simms and Stephenson
Sex. Transm. Infect. 2000;76:80-87.
FULL TEXT  

Management of genital Chlamydia trachomatis infections
DTB 1994;32:87-88.
ABSTRACT | FULL TEXT  

Adolescent Medicine
Irwin and Shafer
JAMA 1992;268:333-335.
ABSTRACT  

Preventing Pelvic Inflammatory Disease
Washington et al.
JAMA 1991;266:2574-2580.
ABSTRACT  

Pelvic Inflammatory Disease
Westrom
JAMA 1991;266:2612-2612.
ABSTRACT