Prevalence, incidence, and correlates of chlamydia and gonorrhea among young adult injection drug users

Purpose: To measure prevalence, incidence, and correlates of chlamydia and gonorrhea among injection drug users (IDUs). Methods: Participants (n=2129; 63% male, 52% white, ages 18-30 years) in five US cities were tested for c hlamydia and gonorrhea by urine LCR assay and completed a standardized ques tionnaire about demographics and recent sexual behavior. Logistic regressio n identified correlates of prevalent infection; incidence rates were calcul ated from 6-month follow-up data. Results: Chlamydia prevalence was 5.2% an d did not differ by gender. Gonorrhea prevalence was 0.2% among men and 2.0 % among women, P < .001. Among men, younger age [OR (95% CI): 0.89 (0.83-0. 96)], age at sexual debut [0.91 (0.83-0.99)], and African American race [2. 92 (1.53-5.59)] were associated with chlamydia. Among women, age at sexual debut [1.16 (1.02-1.31)] and commercial sex [1.96 (1.03-3.74)] were associa ted with chlamydia, and with gonorrhea [1.27 (1.04-1.56)] and [5.17 (1.66-1 6.11)], respectively. At 6 months, the cumulative incidence of chlamydia wa s 1.7% among men and 4.4% among women, P=.03: no men and 1.3% of women test ed positive for gonorrhea, P=.01. Implications: Prevalence and correlates o f chlamydia and gonorrhea were similar to other samples, suggesting that sc reening criteria need not be modified for IDU populations. The number of be havioral correlates identified was limited, perhaps unmeasured sexual-netwo rk-level factors play a role in determining sexually transmitted disease (S TD) prevalence. (C) 2001 Elsevier Science Inc. All rights reserved.