This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (151)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Bacterial Infections  • Sexually Transmitted Diseases  • Pediatrics  • Adolescent Medicine  • Women's Health  • Women's Health, Other  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

William C. Miller, MD, PhD, MPH; Carol A. Ford, MD; Martina Morris, PhD; Mark S. Handcock, PhD; John L. Schmitz, PhD; Marcia M. Hobbs, PhD; Myron S. Cohen, MD; Kathleen Mullan Harris, PhD; J. Richard Udry, PhD

JAMA. 2004;291:2229-2236.

Context  Chlamydial and gonococcal infections are important causes of pelvic inflammatory disease, ectopic pregnancy, and infertility. Although screening for Chlamydia trachomatis is widely recommended among young adult women, little information is available regarding the prevalence of chlamydial and gonococcal infections in the general young adult population.

Objective  To determine the prevalence of chlamydial and gonoccoccal infections in a nationally representative sample of young adults living in the United States.

Design, Setting, and Participants  Cross-sectional analyses of a prospective cohort study of a nationally representative sample of 14 322 young adults aged 18 to 26 years. In-home interviews were conducted across the United States for Wave III of The National Longitudinal Study of Adolescent Health (Add Health) from April 2, 2001, to May 9, 2002. This study sample represented 66.3% of the original 18 924 participants in Wave I of Add Health. First-void urine specimens using ligase chain reaction assay were available for 12 548 (87.6%) of the Wave III participants.

Main Outcome Measures  Prevalences of chlamydial and gonococcal infections in the general young adult population, and by age, self-reported race/ethnicity, and geographic region of current residence.

Results  Overall prevalence of chlamydial infection was 4.19% (95% confidence interval [CI], 3.48%-4.90%). Women (4.74%; 95% CI, 3.93%-5.71%) were more likely to be infected than men (3.67%; 95% CI, 2.93%-4.58%; prevalence ratio, 1.29; 95% CI, 1.03-1.63). The prevalence of chlamydial infection was highest among black women (13.95%; 95% CI, 11.25%-17.18%) and black men (11.12%; 95% CI, 8.51%-14.42%); lowest prevalences were among Asian men (1.14%; 95% CI, 0.40%-3.21%), white men (1.38%; 95% CI, 0.93%-2.03%), and white women (2.52%; 95% CI, 1.90%-3.34%). Prevalence of chlamydial infection was highest in the south (5.39%; 95% CI, 4.24%-6.83%) and lowest in the northeast (2.39%; 95% CI, 1.56%-3.65%). Overall prevalence of gonorrhea was 0.43% (95% CI, 0.29%-0.63%). Among black men and women, the prevalence was 2.13% (95% CI, 1.46%-3.10%) and among white young adults, 0.10% (95% CI, 0.03%-0.27%). Prevalence of coinfection with both chlamydial and gonococcal infections was 0.030% (95% CI, 0.18%-0.49%).

Conclusions  The prevalence of chlamydial infection is high among young adults in the United States. Substantial racial/ethnic disparities are present in the prevalence of both chlamydial and gonococcal infections.

Author Affiliations: Departments of Medicine (Drs Miller, Ford, Hobbs, and Cohen), Pediatrics (Dr Ford), Microbiology and Immunology (Drs Hobbs and Cohen), and Pathology and Laboratory Medicine (Dr Schmitz), School of Medicine; Departments of Epidemiology (Dr Miller) and Maternal and Child Health (Dr Udry), School of Public Health; Department of Sociology (Drs Harris and Udry); and the Carolina Population Center (Drs Harris and Udry), University of North Carolina at Chapel Hill, Chapel Hill; and Departments of Sociology and Statistics (Drs Morris and Handcock), University of Washington, Seattle.

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

RELATED LETTERS

Prevalence of Chlamydial and Gonococcal Infections Among Young Adults
Charlotte A. Gaydos, Kelly T. McKee, Jr, Thomas C. Quinn, and Joel C. Gaydos
JAMA. 2004;292(7):801.
EXTRACT | FULL TEXT  

Prevalence of Chlamydial and Gonococcal Infections Among Young Adults—Reply
William C. Miller, Carol A. Ford, Marcia M. Hobbs, Myron S. Cohen, John L. Schmitz, Kathleen Mullan Harris, Mark S. Handcock, and Martina Morris
JAMA. 2004;292(7):801-802.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

C3H Male Mice with Severe Combined Immunodeficiency Cannot Clear a Urethral Infection with a Human Serovar of Chlamydia trachomatis
Pal et al.
Infect. Immun. 2009;77:5602-5607.
ABSTRACT | FULL TEXT  

Inflammasome-dependent Caspase-1 Activation in Cervical Epithelial Cells Stimulates Growth of the Intracellular Pathogen Chlamydia trachomatis
Abdul-Sater et al.
J. Biol. Chem. 2009;284:26789-26796.
ABSTRACT | FULL TEXT  

Chlamydia trachomatis infection during pregnancy and the risk of preterm birth: a case-control study
Silveira et al.
Int J STD AIDS 2009;20:465-469.
ABSTRACT | FULL TEXT  

Depression, Sexually Transmitted Infection, and Sexual Risk Behavior Among Young Adults in the United States
Khan et al.
Arch Pediatr Adolesc Med 2009;163:644-652.
ABSTRACT | FULL TEXT  

Inflammation in Reproductive Disorders
Weiss et al.
Reproductive Sciences 2009;16:216-229.
ABSTRACT  

Protection of Wild-Type and Severe Combined Immunodeficiency Mice against an Intranasal Challenge by Passive Immunization with Monoclonal Antibodies to the Chlamydia trachomatis Mouse Pneumonitis Major Outer Membrane Protein
Pal et al.
Infect. Immun. 2008;76:5581-5587.
ABSTRACT | FULL TEXT  

The Influence of Role Status on Risky Sexual Behavior Among African Americans During the Transition to Adulthood
Kogan et al.
Journal of Black Psychology 2008;34:399-420.
ABSTRACT  

Male Genital Tract Chlamydial Infection: Implications for Pathology and Infertility
Cunningham and Beagley
Biol. Reprod. 2008;79:180-189.
ABSTRACT | FULL TEXT  

Psychosocial Predictors of HIV-Associated Sexual Behaviors and the Efficacy of Prevention Interventions in Adolescents at-Risk for HIV Infection: What Works and What Doesn't Work?
DiClemente et al.
Psychosom. Med. 2008;70:598-605.
ABSTRACT | FULL TEXT  

Moving Upstream: Ecosocial and Psychosocial Correlates of Sexually Transmitted Infections Among Young Adults in the United States
Buffardi et al.
AJPH 2008;98:1128-1136.
ABSTRACT | FULL TEXT  

Epidemiology of chlamydial infection: are we losing ground?
Miller
Sex. Transm. Infect. 2008;84:82-86.
ABSTRACT | FULL TEXT  

Concordance of chlamydia trachomatis infections within sexual partnerships
Rogers et al.
Sex. Transm. Infect. 2008;84:23-28.
ABSTRACT | FULL TEXT  

Obesity, Albuminuria, and Urinalysis Findings in US Young Adults from the Add Health Wave III Study
Ferris et al.
CJASN 2007;2:1207-1214.
ABSTRACT | FULL TEXT  

Structural and Functional Analyses of the Major Outer Membrane Protein of Chlamydia trachomatis
Sun et al.
J. Bacteriol. 2007;189:6222-6235.
ABSTRACT | FULL TEXT  

Gonorrhea and Chlamydia in the United States among Persons 14 to 39 Years of Age, 1999 to 2002
Datta et al.
ANN INTERN MED 2007;147:89-96.
ABSTRACT | FULL TEXT  

Screening for Chlamydial Infection: An Evidence Update for the U.S. Preventive Services Task Force
Meyers et al.
ANN INTERN MED 2007;147:135-142.
ABSTRACT | FULL TEXT  

Sexually transmitted diseases in the USA: temporal trends
Aral et al.
Sex. Transm. Infect. 2007;83:257-266.
ABSTRACT | FULL TEXT  

Mycoplasma genitalium Among Young Adults in the United States: An Emerging Sexually Transmitted Infection
Manhart et al.
AJPH 2007;97:1118-1125.
ABSTRACT | FULL TEXT  

Masculine Beliefs, Parental Communication, and Male Adolescents' Health Care Use
Marcell et al.
Pediatrics 2007;119:e966-e975.
ABSTRACT | FULL TEXT  

Intranasal Vaccination with a Secreted Chlamydial Protein Enhances Resolution of Genital Chlamydia muridarum Infection, Protects against Oviduct Pathology, and Is Highly Dependent upon Endogenous Gamma Interferon Production
Murthy et al.
Infect. Immun. 2007;75:666-676.
ABSTRACT | FULL TEXT  

Sexual and Drug Behavior Patterns and HIV and STD Racial Disparities: The Need for New Directions
Hallfors et al.
AJPH 2007;97:125-132.
ABSTRACT | FULL TEXT  

A decade in review: building on the experiences of past adolescent STI/HIV interventions to optimise future prevention efforts
Sales et al.
Sex. Transm. Infect. 2006;82:431-436.
ABSTRACT | FULL TEXT  

Chlamydia trachomatis and Neisseria gonorrhoeae Infections Among Men and Women Entering California Prisons
Bernstein et al.
AJPH 2006;96:1862-1866.
ABSTRACT | FULL TEXT  

Prevalence of HIV Infection Among Young Adults in the United States: Results From the Add Health Study
Morris et al.
AJPH 2006;96:1091-1097.
ABSTRACT | FULL TEXT  

Use of Flocked Swabs and a Universal Transport Medium To Enhance Molecular Detection of Chlamydia trachomatis and Neisseria gonorrhoeae.
Chernesky et al.
J. Clin. Microbiol. 2006;44:1084-1086.
ABSTRACT | FULL TEXT  

Vaccination with the Chlamydia trachomatis Major Outer Membrane Protein Can Elicit an Immune Response as Protective as That Resulting from Inoculation with Live Bacteria
Pal et al.
Infect. Immun. 2005;73:8153-8160.
ABSTRACT | FULL TEXT  

Screening Sexually Active Adolescents for Chlamydia trachomatis : What About the Boys?
Tebb et al.
AJPH 2005;95:1806-1810.
ABSTRACT | FULL TEXT  

Sexual Activity Among Adolescents in Romantic Relationships With Friends, Acquaintances, or Strangers
Kaestle and Halpern
Arch Pediatr Adolesc Med 2005;159:849-853.
ABSTRACT | FULL TEXT  

Predicting Adolescents' Longitudinal Risk for Sexually Transmitted Infection: Results From the National Longitudinal Study of Adolescent Health
Ford et al.
Arch Pediatr Adolesc Med 2005;159:657-664.
ABSTRACT | FULL TEXT  

Systematic Review: Noninvasive Testing for Chlamydia trachomatis and Neisseria gonorrhoeae
Cook et al.
ANN INTERN MED 2005;142:914-925.
ABSTRACT | FULL TEXT  

Up-Regulation of the JAK/STAT1 Signal Pathway during Chlamydia trachomatis Infection
Lad et al.
J. Immunol. 2005;174:7186-7193.
ABSTRACT | FULL TEXT  

Young Age at First Sexual Intercourse and Sexually Transmitted Infections in Adolescents and Young Adults
Kaestle et al.
Am J Epidemiol 2005;161:774-780.
ABSTRACT | FULL TEXT  

Impact of Patient Characteristics on Performance of Nucleic Acid Amplification Tests and DNA Probe for Detection of Chlamydia trachomatis in Women with Genital Infections
Marrazzo et al.
J. Clin. Microbiol. 2005;43:577-584.
ABSTRACT | FULL TEXT  

Screening for Chlamydia trachomatis in Women 15 to 29 Years of Age: A Cost-Effectiveness Analysis
Hu et al.
ANN INTERN MED 2004;141:501-513.
ABSTRACT | FULL TEXT  

Chlamydia Screening: Expanding the Scope
Stamm
ANN INTERN MED 2004;141:570-572.
FULL TEXT  

Journal Watch
Arch. Dis. Child. 2004;89:888-889.
FULL TEXT  

Prevalence of Chlamydial and Gonococcal Infections Among Young Adults
Gaydos et al.
JAMA 2004;292:801-801.
FULL TEXT  

Asymptomatic Chlamydial Infection Most Prevalent in Blacks
JWatch Emergency Med. 2004;2004:9-9.
FULL TEXT  

Prevalence of Chlamydial and Gonococcal Infections in Young Adults
JWatch General 2004;2004:3-3.
FULL TEXT