Knock-knock: A population-based survey of risk behavior, health care access, and Chlamydia trachomatis infection among low-income women in the San Francisco Bay area

To estimate the prevalence of urogenital chlamydial infection among young, low-income women in northern California and to describe correlates of infec tion, a population-based door-to-door household cluster survey was conducte d from 1996 through 1998. The participants included 1439 women 18-29 years of age, with a mean age of 24 years, most of whom were African American (43 %) or Latina (23%) and had a median income of $500-$999 per month. Most (94 %) had received health care in the past year, and similar to 50% was covere d by state insurance programs. Although more than half (62%) had had a rece nt pelvic examination, only 42% had recently used a condom with a new partn er. The prevalence of urogenital chlamydial infection was 3.2% (95% confide nce interval, 2.2%-4.2%). Women with chlamydia were more likely to be young er (18-21 years of age) and nonwhite and to have lower socioeconomic status . These data demonstrated an 2-3-fold greater burden of infection than rout ine surveillance data have suggested.