Abstract
Objectives Studies conducted in the 1980s, when there was limited chlamydia screening, showed high positivity, 23%–30%, among American Indian women. In the 1990s, chlamydia screening and treatment programs were implemented in a variety of settings serving American Indian women including Indian Health Service (IHS) clinics. Yet, a 2000–2001 national survey documented a chlamydia prevalence of 13.3% among young American Indian women, five times higher than the prevalence among whites. The purpose of this analysis was to determine the chlamydia positivity and risk factors for chlamydia among women screened in Indian Health Service (IHS) clinics participating in the National Infertility Prevention Program in 2003. Methods Data were analyzed from 11,485 chlamydia tests performed among women universally screened in 23 IHS clinics in three states (Montana, North Dakota, South Dakota). Sexual risk history and clinical data were collected in the Montana IHS clinics and used to assess risk factors for chlamydial infection in a multivariate logistic regression model. Results Chlamydia positivity was highest among 15–19 year old women screened in IHS clinics (state range: 15.3%–18.6%). Positivity decreased with age but remained high even among women aged 30–34 years. Young age and having had multiple or new sex partners in the last 90 days were associated with an increased risk of chlamydia; however, chlamydia positivity was greater than 6.7% for women with no known risk factors. Conclusions A greater emphasis on chlamydia screening and treatment should be a component of any program whose goal is to improve the reproductive health of American Indian women.
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Acknowledgements
The authors would like to thank the following people for their help with the collection of the data from the Indian Health Service clinics and their review of this manuscript: Yvonne Hamby, JSI Research and Training Institute, Denver, CO; Laurie Kops and Susanne Zanto, Montana Department of Public Health, Helena, MT; Kirby Kruger, North Dakota Department of Health, Bismarck, ND; and Dave Morgan, South Dakota Department of Health, Pierre, SD.
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Dicker, L.W., Mosure, D.J., Kay, R.S. et al. An Ongoing Burden: Chlamydial Infections among Young American Indian Women. Matern Child Health J 12 (Suppl 1), 25–29 (2008). https://doi.org/10.1007/s10995-007-0293-1
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DOI: https://doi.org/10.1007/s10995-007-0293-1