TRENDS IN THE PREVALENCE OF CHLAMYDIAL INFECTIONS - THE IMPACT OF COMMUNITY-WIDE TESTING

Background: Evaluation of existing testing programs should guide the n ational effort to expand programs for the prevention of chlamydial inf ections, The Columbus (Ohio) Health Department instituted community-wi de testing for Chlamydia trachomatis in 1988. Goals: To assess trends in the prevalence of chlamydial infection, the coverage of screening, and concurrent trends in the prevalence of gonorrhea. Study Design: Th is was a cross-sectional study of women 15. to 44 years of age tested for C. trachomatis at over 50 provider sites in Columbus, Ohio, from 1 989 to 1992. Results: The prevalence of chlamydial infection among all women tested decreased by 33% from 1989 to 1992, Prevalence decreased least (19%) among black women 15 to 19 years of age, the group with t he highest initial prevalence (20.2%), even though 42% of this populat ion in the city was tested, Prevalence did not decrease at all among p renatal patients 15 to 19 years of age, For women tested for both gono rrhea and chlamydia, gonorrhea decreased by 39% during the 4-year peri od. Conclusions: Screening appeared to have limited effect on the prev alence of chlamydial infection for groups with highest initial prevale nce, despite the relatively high percentage of the population tested. Expanding screening programs to include men and instituting behavioral interventions may be necessary to reduce more rapidly the prevalence of chlamydia among these women.