RISK FOR GONOCOCCAL AND CHLAMYDIAL CERVICITIS IN ADOLESCENT FEMALES -INCIDENCE AND RECURRENCE IN A PROSPECTIVE COHORT STUDY

Purpose: This study attempted to determine the incidence and risk for gonococcal and chlamydial cervicitis among sexually active urban adole scent females. Methods: The study design is a prospective cohort study . A cohort of 216 sexually active females were followed with repeat se xually transmitted diseases screening for 12-24 months. Subjects posit ive on any retest (FU) were compared with those who remained negative on all FU. Subjects were interviewed for history and screened for endo cervical gonococcal and chlamydial infection. Results: The number of v isits per patient ranged from 2 to 9 (median, 3). The initial Chlamydi a trachomatis and Neisseria gonorrhoeae rates were 23.2 and 11.6%, res pectively. The cumulative FU positive rates were 20.8% for C. trachoma tis and 17.1% for N. gonorrhoeae. Although the initial gonococcal infe ction was a significant risk for a subsequent infection by C. trachoma tis (p = .05) and N. gonorrhoeae (p = .001), the initial C. trachomati s status was not predictive of subsequent infections. The number of pa rtners was not predictive of subsequent infections with either. In the entire study period, 86 patients had at least one episode of C. trach omatis and N. gonorrhoeae infection was confirmed in 52; 20 patients h ad recurrent cervicitis. During the study, 101 episodes of C. trachoma tis and 68 episodes of N. gonorrhoeae infections were identified. Thos e with recurrent cervicitis (9.3%) were responsible for 33% of all cer vicitis episodes identified during the study. Conclusions: Adolescents in our study were at high risk for cervicitis, particularly as a resu lt of C. trachomatis. Risk for subsequent C. trachomatis cervicitis wa s the same among initially positive and negative groups. Our data unde rscore the importance of repeat screening for sexually transmitted inf ections and treatment of contacts of adolescent females.