Assessment of risk for pelvic inflammatory disease in an urban sexual health population

Objectives: To determine the sexual and demographic risk factors for the ac quisition of presumptive pelvic inflammatory disease (PID). Methods: A retrospective, case-control study in women, who attended the Syd ney Sexual Health Centre (SSHC), between April 1991 and December 1997. Logi stic regression analysis was used to adjust for confounding variables. Results: 741 women with PID and an equal number of controls were included. Cases were significantly younger than controls (p<0.001). 42% of cases were burn in north or South East Asia, compared with 12% of the controls (p<0.0 01). The adjusted odds ratio for being born in north or South East Asia was 2.8 (95% CI 1.70-4.46), for not speaking English at home was 1.6 (95% CI 1 .02-2.55), for having had previous PID was 5.9 (95% CI 3.59-9.73), and for being employed in the: commercial sex industry and being born in north or S outh East Asia was 2.8 (95% CI 1.22-6.22). Women aged 15-19 were at conside rable risk of developing PID (OR 5.3 (95% CI 2.76-10.11)). Women with previ ous human papillomavirus infection were significantly less likely to develo p PID (OR 0.6 C95% CI 0.42-0.79)). The use of IUCDs (OR 4.5 (95% CI 2.14-9. 39)), condoms (OR 1.4 (95% CI 1.03-1.87)), and not using contraception (OR 1.8 (95% CI 1.20-2.76)) was each associated with an increased risk. Conclusions: Several measures may help to reduce the burden of PID. Women s hould be encouraged to delay the onset of sexual activity and IUCDs should not be used in young women. Sexual health services for women whose home lan guage is not English, and for commercial sex workers born in north or South East Asia should be improved.