CDC, National Chlamydia Coalition Partner To Raise Awareness, Testing Rates

The National Chlamydia Coalition is partnering with the Centers for Disease Control and Prevention to increase public awareness and screening efforts for chlamydia, the most common sexually transmitted infection in the U.S., the Wall Street Journal reports. According to CDC, there were 1.1 million recorded cases of chlamydia in 2007, although experts estimate that there are twice as many cases that are not detected largely because the infection often causes few symptoms and many people go unscreened. The infection is three times more common in women than men, which experts say could be because men eliminate it from their bodies more readily than women. Chlamydia is treatable with a single dose of antibiotics, but if left untreated, it can lead to infertility or increased risk for ectopic pregnancies in women.

CDC recommends that all sexually active women younger than age 26 be tested annually for the infection, as well as older women who have had a change of sexual partners. However, fewer than 40% of women in those groups are tested, the Journal reports. Chlamydia is particularly prevalent in women ages 15 to 19 and blacks, although sample studies have shown nearly 10% of all female Army recruits, 10% of female college freshmen and 14% of women in managed care plans are infected with chlamydia.

Despite its prevalence, chlamydia is one of the least known STIs, which has compounded the difficulty of promoting screening efforts, the Journal reports. It causes few symptoms, and many people are unaware they were exposed to it. According to the Journal, many patients do not ask to be screened for the disease because the few symptoms it causes -- such as bleeding between periods, occasional vaginal discharge, pain during intercourse, pelvic pain in women, and burning upon urination in men -- are common to many conditions. While most screening efforts aim to identify active cases in younger women, there is a serious risk of infertility to older women who were exposed to the bacteria when they were younger, the Journal reports.

According to the Journal, the chlamydia bacteria can move to a woman's upper genital tract and set off pelvic inflammatory disease, which often leaves inflammation and scar tissue that obstructs a woman's fallopian tubes and fertilization. PID is the most common cause of ectopic pregnancy and can cause endometriosis, a condition in which small portions of the uterine lining tissue grow outside the uterus, which can cause infertility and pain. Miklos Toth, a New York City-based ob-gyn, said, "It's not the infection itself but the body's response to get rid of the bacteria that causes scarring. And even if just some fragments of the bacteria remain, the immune system thinks an active infection is still present."














According to the Journal, about 25% of women treated for chlamydia are re-infected within six months likely because of a partner who was not treated. CDC recommends that doctors prescribe a second course of antibiotics for partners of people with the infection. However, many doctors do not screen for or discuss chlamydia during office visits with their patients, especially pediatricians who may be uncomfortable discussing sexual activity with their younger patients, the Journal reports. Lynn Barclay, president of the American Social Health Association, said, "A lot of health care providers aren't making the connection when they are dealing with adolescents. But to pretend that teenagers aren't having sex is very dangerous."

The Journal reports that the issue of how minors can pay for chlamydia testing can also create barriers. All 50 states allow minors to be tested and treated for STIs without parental consent. However, if a minor's health insurance is provided by his or her parents, a lab fee listed on an explanation of benefits report for the testing could be considered a breach of confidentiality. Although some doctors suggest that minors pay the $40 to $90 cost for the test in cash, many refer younger patients to STI or family planning clinics that offer low- or no-cost testing. The Journal reports that CDC, in partnership with Johns Hopkins University, funds a pilot program for residents of Maryland; West Virginia; Washington, D.C.; Denver; and parts of Illinois that allows minors to request no-cost testing kits over the Internet. The tests are self-administered and mailed in for evaluation. The results can then be sent via phone, e-mail or regular mail. Los Angeles County, Calif., in June started a similar program for female residents ages 15 to 25.

John Douglas, director of CDC's division of STI prevention, said that chlamydia screening "is a lot less than the cost of fertility treatments." He added, "You'd think this would be a no-brainer. That's why we're trying to get the message out" (Beck, Wall Street Journal, 6/30).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


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