Why Are Rates of Reported Chlamydia Changing in the United States? Insights From the National Job Training Program.
Journal
Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941
Informations de publication
Date de publication:
01 03 2021
01 03 2021
Historique:
pubmed:
11
9
2020
medline:
25
5
2021
entrez:
10
9
2020
Statut:
ppublish
Résumé
In 2010 to 2017, rates of reported chlamydia decreased among young Black women but increased for White women and all men. Because chlamydia case rates can be influenced by changes in prevalence, screening, and other factors, we compared chlamydia prevalence trends in a sentinel population with national case rate trends to understand potential drivers of case rate trends. Chlamydia prevalence was calculated annually among 16- to 24-year-old entrants to the National Job Training Program (NJTP) in 2010 to 2017. An expectation-maximization-based maximum likelihood approach was used to adjust for misclassification due to imperfect test sensitivity and specificity. Models were stratified by sex, age, and race/ethnicity. A statistically significant trend in prevalence was defined as nonoverlapping 95% confidence intervals comparing 2010 and 2017. Trends in chlamydia prevalence were compared with trends in case rates using percentage change over time; relative changes ≥10% were considered meaningful. Among NJTP entrants in 2010 to 2017, chlamydia prevalence was stable for all Black women, whereas case rates decreased for adolescents (-12%) and were stable for 20- to 24-year-olds (-4%). Among adolescent White women, prevalence was stable, whereas case rates increased (+30%). For White women aged 20 to 24 years, prevalence increased +62% and case rates increased +43%. Trends in prevalence differed from trends in case rates for all subgroups of men. Prevalence trends in this sentinel population differed from national case rate trends for Black women, White women, and men, suggesting potential decreased screening among Black women aged 16 to 19 years, increased prevalence among White women aged 20 to 24 years, and increased screening among men.
Sections du résumé
BACKGROUND
In 2010 to 2017, rates of reported chlamydia decreased among young Black women but increased for White women and all men. Because chlamydia case rates can be influenced by changes in prevalence, screening, and other factors, we compared chlamydia prevalence trends in a sentinel population with national case rate trends to understand potential drivers of case rate trends.
METHODS
Chlamydia prevalence was calculated annually among 16- to 24-year-old entrants to the National Job Training Program (NJTP) in 2010 to 2017. An expectation-maximization-based maximum likelihood approach was used to adjust for misclassification due to imperfect test sensitivity and specificity. Models were stratified by sex, age, and race/ethnicity. A statistically significant trend in prevalence was defined as nonoverlapping 95% confidence intervals comparing 2010 and 2017. Trends in chlamydia prevalence were compared with trends in case rates using percentage change over time; relative changes ≥10% were considered meaningful.
RESULTS
Among NJTP entrants in 2010 to 2017, chlamydia prevalence was stable for all Black women, whereas case rates decreased for adolescents (-12%) and were stable for 20- to 24-year-olds (-4%). Among adolescent White women, prevalence was stable, whereas case rates increased (+30%). For White women aged 20 to 24 years, prevalence increased +62% and case rates increased +43%. Trends in prevalence differed from trends in case rates for all subgroups of men.
CONCLUSIONS
Prevalence trends in this sentinel population differed from national case rate trends for Black women, White women, and men, suggesting potential decreased screening among Black women aged 16 to 19 years, increased prevalence among White women aged 20 to 24 years, and increased screening among men.
Identifiants
pubmed: 32910033
pii: 00007435-202103000-00003
doi: 10.1097/OLQ.0000000000001284
pmc: PMC7899293
mid: NIHMS1663174
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
152-160Subventions
Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Informations de copyright
Copyright © 2020 American Sexually Transmitted Diseases Association. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest and Sources of Funding: The authors report no known conflicts of interest or relevant financial disclosures.
Références
Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. STD surveillance reports. (CDC web site). Available at: https://www.cdc.gov/std/stats/archive.htm . Accessed January 30, 2020.
Hsieh HL, Huppert J, Patel CG, et al. The impact of the American College of Obstetricians and Gynecologists guideline changes in Pap tests on annual chlamydia test rates. J Adolesc Health 2017; 61:440–445.
Naimer MS, Kwong JC, Bhatia D, et al. The effect of changes in cervical cancer screening guidelines on chlamydia testing. Ann Fam Med 2017; 15:329–334.
US Food and Drug Administration. FDA News Release: FDA clears first diagnostic tests for extragenital testing for chlamydia and gonorrhea. (FDA web site). Available at: https://www.fda.gov/news-events/press-announcements/fda-clears-first-diagnostic-tests-extragenital-testing-chlamydia-and-gonorrhea . Accessed March 2, 2020.
Torrone E, Papp J, Weinstock H; Centers for Disease Control and Prevention (CDC). Prevalence of Chlamydia trachomatis genital infection among persons aged 14–39 years—United States, 2007–2012. MMWR Morb Mortal Wkly Rep 2014; 63:834–838.
Bradley H, Satterwhite CL. Prevalence of Neisseria gonorrhoeae infections among men and women entering the National Job Training Program—United States, 2004–2009. Sex Transm Dis 2012; 39:49–54.
Satterwhite CL, Tian LH, Braxton J, et al. Chlamydia prevalence among women and men entering the National Job Training Program: United States, 2003–2007. Sex Transm Dis 2010; 37:63–67.
Learner ER, Torrone EA, Fine JP, et al. Chlamydia prevalence trends among women and men entering the National Job Training Program from 1990 through 2012. Sex Transm Dis 2018; 45:554–559.
U.S. Department of Labor Office of Job Corps. Policy and Requirements Handbook 2016. Available at: https://www.jobcorps.gov/reports/job-corps-policy-and-requirements-handbook . Accessed August 10, 2020.
US Department of Labor. US Department of Labor Job Corps Annual Report 2009. Available at: https://s3-us-west-2.amazonaws.com/jobcorps.gov/2017-04/Job_Corps-py08report.pdf . Accessed August 10, 2020.
Cuzick J. A Wilcoxon-type test for trend. Stat Med 1985; 4:87–90.
Magder LS, Hughes JP. Logistic regression when the outcome is measured with uncertainty. Am J Epidemiol 1997; 146:195–203.
Centers for Disease Control and Prevention, National Notifiable Diseases Surveillance System. Chlamydia trachomatis infection 2010 case definition. (CDC web site). Available at: https://wwwn.cdc.gov/nndss/conditions/chlamydia-trachomatis-infection/case-definition/2010/ . Accessed April 11, 2019.
Fowler CI, Gable J, Wang J, et al. Family Planning Annual Report: 2017 National Summary. Research Triangle Park, NC: RTI International, 2018.
Mehtani NJ, Schumacher CM, Johnsen LE, et al. Three years post-Affordable Care Act sexually transmitted disease clinics remain critical among vulnerable populations. Am J Prev Med 2018; 55:111–114.
Johnson Jones ML, Chapin-Bardales J, Bizune D, et al. Extragenital chlamydia and gonorrhea among community venue–attending men who have sex with men—Five cities, United States, 2017. Morb Mortal Wkly Rep 2019; 68:321–325.
Chan PA, Robinette A, Montgomery M, et al. Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae : A review of the literature. Infect Dis Obstet Gynecol 2016; 2016:5758387.
Gay Men's Health Equity Work Group. Prioritizing the health of MSM: Extragenital STD screening call-to-action. (NCSD web site). Available at: https://www.ncsddc.org/resource/extragenital-call-action/ . Accessed April 3, 2020.
Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64(RR-03):1–137.
Stahlman S, Seliga N, Oetting AA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64(RR-03):1–137.
Park JY, Zimmerman L, Stempinski K, et al. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in an urban public hospital pregnancy termination clinic. Int J STD AIDS 2017; 28:1164–1168.
Burghardt NO, Chow JM, Steiner A, et al. Trends in chlamydia screening, test positivity, and treatment among females in California juvenile detention facilities, 2003–2014. Sex Transm Dis 2016; 43:12–17.
Owings AJ, Clark LL, Rohrbeck P. Incident and recurrent Chlamydia trachomatis and Neisseria gonorrhoeae infections, active component, U.S. Armed Forces, 2010–2014. MSMR 2016; 23:20–28.
Nsubuga P, White ME, Thacker SB, et al. Public health surveillance: A tool for targeting and monitoring interventions. In: Jamison DT, Breman JG, Measham AR, et al., eds. Disease Control Priorities in Developing Countries 2nd ed. Washington, DC: The International Bank for Reconstruction and Development/The World Bank, 2006:997–1015. Chapter 53. Available at: https://www.ncbi.nlm.nih.gov/books/NBK11770/ . Co-published by Oxford University Press, New York.
Farley TA, Cohen DA, Elkins W. Asymptomatic sexually transmitted diseases: The case for screening. Prev Med 2003; 36:502–509.
Korenromp EL, Sudaryo MK, de Vlas SJ, et al. What proportion of episodes of gonorrhoea and chlamydia becomes symptomatic?Int J STD AIDS 2002; 13:91–101.
Association of Public Health Laboratories. 2013 Chlamydia and gonorrhea clinical laboratory practices survey: Summary data report. (Association of Public Health Laboratories web site). Available at: https://www.aphl.org/aboutAPHL/publications/ . Accessed January 23, 2020.
Patel CG, Tao G. The significant impact of different insurance enrollment criteria on the HEDIS chlamydia screening measure for young women enrolled in Medicaid and commerical insurance plans. Sex Transm Dis 2015; 42:575–579.