CHLAMYDIA-TRACHOMATIS INFECTION AMONG HISPANIC WOMEN IN THE CALIFORNIA-MEXICO BORDER AREA, 1993 - ESTABLISHING SCREENING CRITERIA IN A PRIMARY-CARE SETTING

Background: Chlamydia prevalence and transmission patterns in Californ ia-Mexico border communities are unknown, and selective screening stra tegies for Hispanic populations have not been evaluated. Goal of this Study: To determine chlamydia prevalence among Hispanic women in the C alifornia-Mexico border area and establish screening criteria. Study D esign: This was a cross-sectional prevalence survey of family planning /prenatal Hispanic clients (n = 2378) in San Diego and Imperial Counti es, California, and Tijuana, Mexico. Results: Overall, chlamydia preva lence was 3.2% (3.3% in California; 2.1% in Mexico). Women born in Mex ico or those who visited Mexico for at least 1 week in the recent past had a prevalence rate similar to women without those characteristics. Multivariate analysis showed that young age (less than 25 years old), unmarried status, or having clinical signs of a chlamydia syndrome (p rimarily cervicitis) or vaginosis independently predicted chlamydia in fection. Applying minimum screening criteria recommended by the Center s for Disease Control would require screening less than half of the cl ients. However, only 69% of infections would be identified. Using surv ey-based criteria (less than 25 years old, unmarried, and clinical sig ns of a chlamydia syndrome) would require screening 64% of clients, bu t would identify 92% of those infected. Conclusion: Chlamydia prevalen ce among Hispanic women seeking reproductive healthcare was similar (< 5%) on both sides of the California-Mexico border. Among Hispanic wome n, using easily obtained demographic data (age and marital status) and clinical signs (primarily cervicitis), an effective selective screeni ng strategy can be implemented.