PREDICTORS OF CHLAMYDIA-TRACHOMATIS INFECTION AMONG FEMALE ADOLESCENTS - A LONGITUDINAL ANALYSIS

Screening guidelines recommend testing all sexually active female adol escents for Chlamydia trachomatis during a pelvic examination at each clinic visit. Such criteria have been based on cross-sectional studies ; new evaluations should take into account multiple clinic visits and assess whether criteria are appropriate when a prior test is negative and risk factors are absent. Because repeated observations on an indiv idual may be correlated, the authors used the generalized estimating e quation method. Little information exists on subsequent risk of infect ion; as control programs develop, approaches targeting high-risk popul ations for recurrent infections are needed. Using data on females aged 15-19 years who visited family planning clinics more than once from 1 988 to 1992 (n = 26,921) in Region X (Alaska, Idaho, Oregon, and Washi ngton), the authors constructed a retrospective cohort. Teens with chl amydia at their first visit were at high risk for subsequent infection (odds ratio = 1.6, 95% confidence interval 1.4-1.7). Among teens unin fected at the first visit and without risk factors at the second, prev alence at the second visit was 6%. When intervisit correlations using the generalized estimating equation method were taken into account, pr edictors of chlamydial infection were consistent with those in previou s cross-sectional studies: cervicitis, friable cervix, and multiple, n ew, or symptomatic sex partner(s). These findings support screening se xually active female adolescents at each visit, even if prior tests re sults are available.