When it comes to diagnosing and treating chlamydia does where a woman lives make a difference? Yes, according to Emory STD researcher Adelbert James PhD, MPH. City dwellers seem to fare better than their rural counterparts.
"Our study shows socio-demographic factors do have an impact on health outcomes," says Dr. James, senior program associate at the Department of Gynecology and Obstetrics, Emory University School of Medicine.
Dr. James' findings were presented at the International Society for Sexually Transmitted Disease Research held jointly with the annual International Union against Sexually Transmitted Infections World Congress, July 29 -- Aug. 1 in Seattle.
In a cross-sectional study, Dr. James' research team reviewed data from 60,000 randomly selected women under 25 years of age who were screened for Chlamydia trachomatis infections at clinics family planning, STD and prenatal clinics in eight southeastern states between 1999 and 2000.
The distance the patients traveled to the clinic was calculated based on their zip code using a commercial software program.
Chlamydia is a bacterial infection of the genital tract that spreads easily through sexual contact. According to the Centers for Disease Control and Prevention (CDC), chlamydia is one of the most common sexually transmitted diseases in the U.S. Each year, nearly 3 million people in the U.S. are infected with the disease. Chlamydia affects both men and women across all age groups but it's particularly prevalent among U.S. teenagers.
"I have to stress the importance of developing new approaches to reducing STDs specifically chlamydia," says Dr. James. "We need to increase access to care by making it more available, affordable and equitable. And not just access to care but we should also be concerned about the distance to care.
"Our study shows that the greater the distance to a treatment facility, the greater a woman's chance for recurrent chlamydial infection," says Dr. James.
Dr. James stresses the importance of an infected woman's sexual partner or partners receiving treatment even though they may not have signs or symptoms. Otherwise, the infection can be passed back and forth resulting in recurrent or further transmission of chlamydia cases.
"We've seen great results with Expedited Partner Therapy which is supported by the CDC," says Dr. James. "In Expedited Partner Therapy, or EPT, when a patient tests positive for chlamydia the healthcare provider either gives or prescribes medication for their partner as well -- that way both parties are treated."
While Dr. James notes EPT is not a standard choice of care, a 2006 CDC report showed Expedited Partner Therapy was a useful option to facilitate partner management in heterosexual men and women with chlamydial infection.
"Chlamydia is an asymptomatic disease in which 80 percent of women there are no signs or symptoms and it is recurrent infections that may lead to complicated and adverse reproductive outcomes such as pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, other sexually transmitted diseases and ultimately infertility," notes Dr. James.
Dr. James' bottom line message, "Because chlamydia is a silent disease, it's important for all sexually active young women to be screened annually and receive an additional follow-up screening within 3 months following treatment."