Co-authors of “Chlamydia Screening Among Adolescents and Young Women: Individual- and Provider-Level Differences in Testing Rates” in addition to Dr. Wiehe are Marc B. Rosenman, M.D., M.S., and Barry P. Katz, Ph.D., of the IU School of Medicine and the Regenstrief Institute, Jane Wang, Ph.D., of the Regenstrief Institute, and J. Dennis Fortenberry, M.D., M.S., of the IU School of Medicine. The study was funded by the National Institutes of Health and the Clarian Value Fund.
Chlamydia symptoms and signs
Chlamydia symptoms usually appear between 1 and 3 weeks after exposure but may not emerge until much later. Chlamydia is known as the ‘silent’ disease as in many people it produces no symptoms. It is estimated that 70-75% of women infected with chlamydia are asymptomatic (have no symptoms) and a significant proportion of men also have no symptoms. Those who do have symptoms of chlamydia may experience:
An increase in vaginal discharge caused by an inflamed cervix;
the need to urinate more frequently, or pain whilst passing urine;
pain during sexual intercourse or bleeding after sex;
lower abdominal pains; irregular menstrual bleeding
How it is transmitted
You can get Chlamydia by having sex with someone who already has it. Chlamydia is most easily passed on through penetrative anal and vaginal sex without a condom, although it can also be transmitted on fingers from one person’s penis or vagina to another.
A pregnant woman who has Chlamydia can pass it on to her baby when it is being born.
Racial Gaps Seen in Chlamydia Screening
All sexually active women under 25 are supposed to be screened for chlamydia. But a new analysis finds that black and Hispanic women are screened at significantly higher rates than white women, and this could help explain why minority women have higher reported rates of the disease.
The study, published in the February issue of Pediatrics, examined the records of more than 23,000 women ages 14 to 25 who visited health care facilities in Indianapolis from 2002 to 2007.
Over all, 58 percent of the women were screened. The youngest women and those with insurance were slightly more likely to be tested than the older and the uninsured. But black women were three times as likely to be tested as white women, and Hispanic women almost 13 times as likely to be tested.
Chlamydia rates are higher among blacks and Hispanics, and this could be a reason to screen them more often than whites. But cervical cancer rates, for example, are also higher among blacks and Hispanics, yet there is no difference by race in screening for that disease. The authors say the stigma attached to a sexually transmitted infection like chlamydia may make clinicians less likely to test white women.
The lead author, Dr. Sarah E. Wiehe, an assistant professor of pediatrics at Indiana University, said these differences in screening might have a significant effect on reported rates of disease. “There is a higher prevalence of chlamydia among certain women,” she said. “We don’t know how much of that is driven by differences in screening.”
By NICHOLAS BAKALAR
The IU School of Medicine and the Regenstrief Institute are located at the campus of Indiana University - Purdue University Indianapolis.
Sarah E. Wiehe, M.D., assistant professor of pediatrics at Indiana University School of Medicine and affiliated scientist at the Regenstrief Institute