GENITAL CHLAMYDIAL DISEASE IN AN URBAN, PRIMARILY HISPANIC, FAMILY-PLANNING CLINIC

Background and Objectives: Although chlamydia is a well-studied diseas e, little is known about the rates of genital chlamydial disease among female Hispanics in urban family planning clinics. Goals: To determin e the prevalence of women with chlamydia in two clinic populations dur ing 1994, We also sought to describe previously identified and novel r isk factors for chlamydial disease in this unique population. Study De sign: We conducted a retrospective case-control analysis in two commun ity clinics in the Washington Heights section of New York City. Result s: In 1994, 4,190 screening tests were done for Chlamydia trachomatis in these clinics, and the prevalence of positive tests was 5.4% (227/4 ,190). The mean age of the women screened was 19.2 years and most were of Hispanic origin (76%), students (51%), and received Medicaid (61%) . Risk factors found to be associated with C. trachomatis infection in cluded young age; earlier age at first coitus; pregnancy at the time o f chlamydia screening; concurrent gonorrheal infection; and the clinic al findings of cervical abnormalities, vaginal discharge, and adnexal tenderness. Hormonal contraception appeared to be protective against c hlamydial infection (odds ratio, 0.36; confidence interval, 0.17-0.77) , Conclusion: Sexually transmitted diseases were common in our populat ion because 5.4% of the women screened had chlamydial infection and 1. 5% had concurrent gonorrheal infection, Our study confirmed risk facto rs established in other populations. These data support the need for e nhanced screening efforts for chlamydia to decrease the prevalence of disease in our population.