Integrating Chlamydia trachomatis Control Services For Males in Female Reproductive Health Programs

Chlamydia trachomatis is the most commonly reported infectious disease in the United States. Although more than 7 cases were reported in 2000 the total number of annual cases—reported and unreported—is estimated to be three million. The majority of severe consequences of untreated chlamydia occur in women. Of women who are not treated 30% will develop pelvic inflammatory disease (PID) and approximately one-third of these will become infertile have ectopic pregnancies or develop chronic pelvic pain. Prevention of these consequences is dependent upon screening to identify asymptomatic infection and effective partner management to decrease the risk of reinfection. Expanded chlamydia screening has resulted in decreases in prevalence among women in sites monitored by the Centers for Disease Control and Prevention (CDC). However these decreases have not been consistently sustained and current levels of prevalence may be associated with lack of chlamydia testing and treatment among males. Indeed case-based reported chlamydia rates among women may be 4–5 times the rates among men because women are more likely to obtain care and because guidelines exist for chlamydia screening among women. These data suggest that male sexually transmitted disease (STD) services need to be improved to ensure that partners of infected women are tested and treated. One approach is to expand strategies aimed at controlling chlamydia to males by integrating male services in programs serving women’s reproductive health needs. (excerpt)