2014 STD Prevention Conference

ATLANTA – A substantial proportion of patients who tested positive for HIV infection in urban emergency departments had not been tested elsewhere, according to a retrospective study of patient records.

The findings suggest that EDs are an ideal venue for identifying new infections and linking patients to appropriate care, Hilda Ndirangu of the Baltimore City Health Department reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

© Dr. A. Harrison; Dr. P. Feorino / CDC

HIV testing in EDs not only helps identify new infections and link patients to care, but also helps re-link previously diagnosed patients to care for better HIV continuum of care outcomes, and can reduce HIV-related disparities, Ms. Ndirangu noted.

Of 27,816 patients tested in Baltimore area EDs between July 2012 and December 2013, 118 had a confirmed positive HIV test, and 68 of the tests were "new positives," while 50 were in patients who had previously tested HIV positive. Of the patients with new positives, 44 (65%) had not been tested at any other publicly funded testing site in the department’s database, Ms. Ndirangu said.

"These findings give merit to the utility of ED testing programs in finding acute HIV positive cases and those who are vulnerable to being infected with HIV," Ms. Ndirangu said.

The Baltimore City Health Department initiated routine HIV testing in EDs in 2008. Since then, more than 93,000 patients have been tested. Of those tests, 493 were positive, and 355 were new positives. Of the new positives, 241 (68%) were linked to care.

The study involved a review of the records of all HIV-positive cases during the study period, and a search of electronic databases to determine whether the patients had ever been tested at any of the publicly funded programs that report HIV testing activities to the Baltimore City Health Department.

HIV remains a major public health problem that disproportionately affects the urban poor, who often use EDs for primary care. The findings, though limited by small sample size, incomplete reporting of negative tests, and the likelihood that some patients with positive tests had been tested somewhere other than at publicly funded test sites in the study area, suggest that HIV testing in EDs reaches patients who do not perceive themselves to be at risk and who thus do not seek testing elsewhere, Ms. Ndirangu said.

"Despite the declining new positivity rates (1.05% in 2008, 0.5% in 2009, 0.5% in 2010, 0.3% in 2011, 0.25% in 2012) Baltimore EDs still surpass the cost-effectiveness threshold of 0.1% for undiagnosed rate that warrants routine testing," she wrote. In Baltimore, the HIV incidence remains high at 81.4/100,000.

Ms. Ndirangu reported having no disclosures.

ATLANTA – A substantial proportion of patients who tested positive for HIV infection in urban emergency departments had not been tested elsewhere, according to a retrospective study of patient records.

The findings suggest that EDs are an ideal venue for identifying new infections and linking patients to appropriate care, Hilda Ndirangu of the Baltimore City Health Department reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

© Dr. A. Harrison; Dr. P. Feorino / CDC

HIV testing in EDs not only helps identify new infections and link patients to care, but also helps re-link previously diagnosed patients to care for better HIV continuum of care outcomes, and can reduce HIV-related disparities, Ms. Ndirangu noted.

Of 27,816 patients tested in Baltimore area EDs between July 2012 and December 2013, 118 had a confirmed positive HIV test, and 68 of the tests were "new positives," while 50 were in patients who had previously tested HIV positive. Of the patients with new positives, 44 (65%) had not been tested at any other publicly funded testing site in the department’s database, Ms. Ndirangu said.

"These findings give merit to the utility of ED testing programs in finding acute HIV positive cases and those who are vulnerable to being infected with HIV," Ms. Ndirangu said.

The Baltimore City Health Department initiated routine HIV testing in EDs in 2008. Since then, more than 93,000 patients have been tested. Of those tests, 493 were positive, and 355 were new positives. Of the new positives, 241 (68%) were linked to care.

The study involved a review of the records of all HIV-positive cases during the study period, and a search of electronic databases to determine whether the patients had ever been tested at any of the publicly funded programs that report HIV testing activities to the Baltimore City Health Department.

HIV remains a major public health problem that disproportionately affects the urban poor, who often use EDs for primary care. The findings, though limited by small sample size, incomplete reporting of negative tests, and the likelihood that some patients with positive tests had been tested somewhere other than at publicly funded test sites in the study area, suggest that HIV testing in EDs reaches patients who do not perceive themselves to be at risk and who thus do not seek testing elsewhere, Ms. Ndirangu said.

"Despite the declining new positivity rates (1.05% in 2008, 0.5% in 2009, 0.5% in 2010, 0.3% in 2011, 0.25% in 2012) Baltimore EDs still surpass the cost-effectiveness threshold of 0.1% for undiagnosed rate that warrants routine testing," she wrote. In Baltimore, the HIV incidence remains high at 81.4/100,000.

Ms. Ndirangu reported having no disclosures.

ATLANTA – A substantial proportion of patients who tested positive for HIV infection in urban emergency departments had not been tested elsewhere, according to a retrospective study of patient records.

The findings suggest that EDs are an ideal venue for identifying new infections and linking patients to appropriate care, Hilda Ndirangu of the Baltimore City Health Department reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

© Dr. A. Harrison; Dr. P. Feorino / CDC

HIV testing in EDs not only helps identify new infections and link patients to care, but also helps re-link previously diagnosed patients to care for better HIV continuum of care outcomes, and can reduce HIV-related disparities, Ms. Ndirangu noted.

Of 27,816 patients tested in Baltimore area EDs between July 2012 and December 2013, 118 had a confirmed positive HIV test, and 68 of the tests were "new positives," while 50 were in patients who had previously tested HIV positive. Of the patients with new positives, 44 (65%) had not been tested at any other publicly funded testing site in the department’s database, Ms. Ndirangu said.

"These findings give merit to the utility of ED testing programs in finding acute HIV positive cases and those who are vulnerable to being infected with HIV," Ms. Ndirangu said.

The Baltimore City Health Department initiated routine HIV testing in EDs in 2008. Since then, more than 93,000 patients have been tested. Of those tests, 493 were positive, and 355 were new positives. Of the new positives, 241 (68%) were linked to care.

The study involved a review of the records of all HIV-positive cases during the study period, and a search of electronic databases to determine whether the patients had ever been tested at any of the publicly funded programs that report HIV testing activities to the Baltimore City Health Department.

HIV remains a major public health problem that disproportionately affects the urban poor, who often use EDs for primary care. The findings, though limited by small sample size, incomplete reporting of negative tests, and the likelihood that some patients with positive tests had been tested somewhere other than at publicly funded test sites in the study area, suggest that HIV testing in EDs reaches patients who do not perceive themselves to be at risk and who thus do not seek testing elsewhere, Ms. Ndirangu said.

"Despite the declining new positivity rates (1.05% in 2008, 0.5% in 2009, 0.5% in 2010, 0.3% in 2011, 0.25% in 2012) Baltimore EDs still surpass the cost-effectiveness threshold of 0.1% for undiagnosed rate that warrants routine testing," she wrote. In Baltimore, the HIV incidence remains high at 81.4/100,000.

Ms. Ndirangu reported having no disclosures.

ATLANTA – Adding a rapid Trichomonas vaginalis test to the adolescent sexually transmitted infection laboratory regimen facilitated on-site diagnosis and treatment at an urban medical center emergency department.

The OSOM rapid trichomonas test provided point of care testing results in 10 minutes, with a sensitivity of 83% and specificity of 99%, Dr. Heather Territo reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention. The prevalence of Trichomonas vaginalis approaches 25% in inner-city adolescents. Prior studies have demonstrated an association between Trichomonas vaginalis and cervical neoplasia, enhanced HIV transmission, and pregnancy complications.

Courtesy CDC

After routine Trichomonas vaginalis testing was implemented at the Women’s and Children’s Hospital of Buffalo, N.Y., in November 2011, 212 females aged 13-20 years were tested in the following year; 13.6% tested positive by rapid test and 15.5% by nucleic acid amplification test (NAAT). In the year before routine testing was implemented, 31 of 234 patients were tested, based on a retrospective chart review. Treatment was administered to 24% and to 7% of patients during the respective study periods, said Dr. Territo of the hospital’s division of emergency medicine.

Additionally, two positive results were found in 20 males tested.

In the emergency department, Trichomonas vaginalis is often diagnosed on the basis of clinical findings; the positive predictive value of this approach is less than 50%. Direct microscopy of vaginal secretions has a sensitivity of about 60%-70%.

The rapid test and the NAAT test results were concordant in 178 of 188 cases (94.6%). Ten of the 33 positive NAAT tests (30%) were negative on the rapid test.

Dr. Territo reported having no relevant financial disclosures.

ATLANTA – Adding a rapid Trichomonas vaginalis test to the adolescent sexually transmitted infection laboratory regimen facilitated on-site diagnosis and treatment at an urban medical center emergency department.

The OSOM rapid trichomonas test provided point of care testing results in 10 minutes, with a sensitivity of 83% and specificity of 99%, Dr. Heather Territo reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention. The prevalence of Trichomonas vaginalis approaches 25% in inner-city adolescents. Prior studies have demonstrated an association between Trichomonas vaginalis and cervical neoplasia, enhanced HIV transmission, and pregnancy complications.

Courtesy CDC

After routine Trichomonas vaginalis testing was implemented at the Women’s and Children’s Hospital of Buffalo, N.Y., in November 2011, 212 females aged 13-20 years were tested in the following year; 13.6% tested positive by rapid test and 15.5% by nucleic acid amplification test (NAAT). In the year before routine testing was implemented, 31 of 234 patients were tested, based on a retrospective chart review. Treatment was administered to 24% and to 7% of patients during the respective study periods, said Dr. Territo of the hospital’s division of emergency medicine.

Additionally, two positive results were found in 20 males tested.

In the emergency department, Trichomonas vaginalis is often diagnosed on the basis of clinical findings; the positive predictive value of this approach is less than 50%. Direct microscopy of vaginal secretions has a sensitivity of about 60%-70%.

The rapid test and the NAAT test results were concordant in 178 of 188 cases (94.6%). Ten of the 33 positive NAAT tests (30%) were negative on the rapid test.

Dr. Territo reported having no relevant financial disclosures.

ATLANTA – Adding a rapid Trichomonas vaginalis test to the adolescent sexually transmitted infection laboratory regimen facilitated on-site diagnosis and treatment at an urban medical center emergency department.

The OSOM rapid trichomonas test provided point of care testing results in 10 minutes, with a sensitivity of 83% and specificity of 99%, Dr. Heather Territo reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention. The prevalence of Trichomonas vaginalis approaches 25% in inner-city adolescents. Prior studies have demonstrated an association between Trichomonas vaginalis and cervical neoplasia, enhanced HIV transmission, and pregnancy complications.

Courtesy CDC

After routine Trichomonas vaginalis testing was implemented at the Women’s and Children’s Hospital of Buffalo, N.Y., in November 2011, 212 females aged 13-20 years were tested in the following year; 13.6% tested positive by rapid test and 15.5% by nucleic acid amplification test (NAAT). In the year before routine testing was implemented, 31 of 234 patients were tested, based on a retrospective chart review. Treatment was administered to 24% and to 7% of patients during the respective study periods, said Dr. Territo of the hospital’s division of emergency medicine.

Additionally, two positive results were found in 20 males tested.

In the emergency department, Trichomonas vaginalis is often diagnosed on the basis of clinical findings; the positive predictive value of this approach is less than 50%. Direct microscopy of vaginal secretions has a sensitivity of about 60%-70%.

The rapid test and the NAAT test results were concordant in 178 of 188 cases (94.6%). Ten of the 33 positive NAAT tests (30%) were negative on the rapid test.

Dr. Territo reported having no relevant financial disclosures.

ATLANTA – An estimated 1 in 15 sexually active adolescent girls has a chlamydial infection, and many of these infections go undiagnosed, according to an analysis of National Health and Nutrition Examination Survey data.

According to 2007-2012 NHANES data, the overall prevalence of chlamydia among sexually active adolescents and adults aged 14-39 years is 1.7%, suggesting that there are 1.8 million infections nationally, Elizabeth Torrone, Ph.D., reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

CDC/Dr. E. Arum; Dr. N. Jacobs

However, only 1.4 million infections are reported annually, according to information from the CDC, suggests that approximately 400,000 infections go undetected each year.

Adolescent girls – and particularly adolescent non-Hispanic black girls – are at highest risk, according to Dr. Torrone.

The estimated overall prevalence among adolescent girls aged 14-19 years in this study was 6.4%. The estimated prevalence among white girls in this age group was 3.2%, and among black girls in this age group it was 18.6%, reported Dr. Torrone of the division of STD prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, Atlanta.

The overall prevalence was 1.4% among males, 2.0% among females, 2.4% among persons aged 14-19 years, 2.9% among those aged 20-24 years, 1.1% among those aged 25-39 years, 2.3% among Mexican Americans, 5.2% among non-Hispanic blacks, and 0.8% among whites.

Having multiple sex partners in the past year was associated with increased prevalence: 3.2% for those with two or more partners, compared with 1.4% among those with one or no partner.

NHANES respondents included in this analysis were 8,330 adolescents and adults aged 14-39 years between 2007 and 2012 who were tested for C. trachomatis using the Gen-Probe Aptima test. Prevalence estimates were based on demographics and self-reported sexual activity measured through audio, computer-assessed self-interviews.

Estimates were weighted to be nationally representative and to account for oversampling and nonresponse, and the number of infections in the population was estimated by multiplying census estimates by weighted prevalence, Dr. Torrone explained.

Chlamydia is the most commonly reported infection in the United States, and annual screening is currently recommended for all sexually active females under age 25 years, she noted.

Since the findings of this study likely represent an underestimate of the true burden of disease because the estimates do not account for nongenital infection and infections in nonsampled populations where prevalence may be higher (such as incarcerated individuals), they highlight a need for targeted interventions to reduce the impact of chlamydia among young African American women and underscore the importance of adhering to the screening recommendations.

"Health care providers should screen all sexually active young females annually and ensure that all sex partners of patients diagnosed with chlamydia are treated appropriately," Dr. Torrone concluded.

Dr. Torrone reported having no disclosures.

ATLANTA – An estimated 1 in 15 sexually active adolescent girls has a chlamydial infection, and many of these infections go undiagnosed, according to an analysis of National Health and Nutrition Examination Survey data.

According to 2007-2012 NHANES data, the overall prevalence of chlamydia among sexually active adolescents and adults aged 14-39 years is 1.7%, suggesting that there are 1.8 million infections nationally, Elizabeth Torrone, Ph.D., reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

CDC/Dr. E. Arum; Dr. N. Jacobs

However, only 1.4 million infections are reported annually, according to information from the CDC, suggests that approximately 400,000 infections go undetected each year.

Adolescent girls – and particularly adolescent non-Hispanic black girls – are at highest risk, according to Dr. Torrone.

The estimated overall prevalence among adolescent girls aged 14-19 years in this study was 6.4%. The estimated prevalence among white girls in this age group was 3.2%, and among black girls in this age group it was 18.6%, reported Dr. Torrone of the division of STD prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, Atlanta.

The overall prevalence was 1.4% among males, 2.0% among females, 2.4% among persons aged 14-19 years, 2.9% among those aged 20-24 years, 1.1% among those aged 25-39 years, 2.3% among Mexican Americans, 5.2% among non-Hispanic blacks, and 0.8% among whites.

Having multiple sex partners in the past year was associated with increased prevalence: 3.2% for those with two or more partners, compared with 1.4% among those with one or no partner.

NHANES respondents included in this analysis were 8,330 adolescents and adults aged 14-39 years between 2007 and 2012 who were tested for C. trachomatis using the Gen-Probe Aptima test. Prevalence estimates were based on demographics and self-reported sexual activity measured through audio, computer-assessed self-interviews.

Estimates were weighted to be nationally representative and to account for oversampling and nonresponse, and the number of infections in the population was estimated by multiplying census estimates by weighted prevalence, Dr. Torrone explained.

Chlamydia is the most commonly reported infection in the United States, and annual screening is currently recommended for all sexually active females under age 25 years, she noted.

Since the findings of this study likely represent an underestimate of the true burden of disease because the estimates do not account for nongenital infection and infections in nonsampled populations where prevalence may be higher (such as incarcerated individuals), they highlight a need for targeted interventions to reduce the impact of chlamydia among young African American women and underscore the importance of adhering to the screening recommendations.

"Health care providers should screen all sexually active young females annually and ensure that all sex partners of patients diagnosed with chlamydia are treated appropriately," Dr. Torrone concluded.

Dr. Torrone reported having no disclosures.

ATLANTA – An estimated 1 in 15 sexually active adolescent girls has a chlamydial infection, and many of these infections go undiagnosed, according to an analysis of National Health and Nutrition Examination Survey data.

According to 2007-2012 NHANES data, the overall prevalence of chlamydia among sexually active adolescents and adults aged 14-39 years is 1.7%, suggesting that there are 1.8 million infections nationally, Elizabeth Torrone, Ph.D., reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

CDC/Dr. E. Arum; Dr. N. Jacobs

However, only 1.4 million infections are reported annually, according to information from the CDC, suggests that approximately 400,000 infections go undetected each year.

Adolescent girls – and particularly adolescent non-Hispanic black girls – are at highest risk, according to Dr. Torrone.

The estimated overall prevalence among adolescent girls aged 14-19 years in this study was 6.4%. The estimated prevalence among white girls in this age group was 3.2%, and among black girls in this age group it was 18.6%, reported Dr. Torrone of the division of STD prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, Atlanta.

The overall prevalence was 1.4% among males, 2.0% among females, 2.4% among persons aged 14-19 years, 2.9% among those aged 20-24 years, 1.1% among those aged 25-39 years, 2.3% among Mexican Americans, 5.2% among non-Hispanic blacks, and 0.8% among whites.

Having multiple sex partners in the past year was associated with increased prevalence: 3.2% for those with two or more partners, compared with 1.4% among those with one or no partner.

NHANES respondents included in this analysis were 8,330 adolescents and adults aged 14-39 years between 2007 and 2012 who were tested for C. trachomatis using the Gen-Probe Aptima test. Prevalence estimates were based on demographics and self-reported sexual activity measured through audio, computer-assessed self-interviews.

Estimates were weighted to be nationally representative and to account for oversampling and nonresponse, and the number of infections in the population was estimated by multiplying census estimates by weighted prevalence, Dr. Torrone explained.

Chlamydia is the most commonly reported infection in the United States, and annual screening is currently recommended for all sexually active females under age 25 years, she noted.

Since the findings of this study likely represent an underestimate of the true burden of disease because the estimates do not account for nongenital infection and infections in nonsampled populations where prevalence may be higher (such as incarcerated individuals), they highlight a need for targeted interventions to reduce the impact of chlamydia among young African American women and underscore the importance of adhering to the screening recommendations.

"Health care providers should screen all sexually active young females annually and ensure that all sex partners of patients diagnosed with chlamydia are treated appropriately," Dr. Torrone concluded.

Dr. Torrone reported having no disclosures.

ATLANTA – An estimated 1 in 15 sexually active adolescent girls has a chlamydial infection, and many of these infections go undiagnosed, according to an analysis of National Health and Nutrition Examination Survey data.

According to 2007-2012 NHANES data, the overall prevalence of chlamydia among sexually active adolescents and adults aged 14-39 years is 1.7%, suggesting that there are 1.8 million infections nationally, Elizabeth Torrone, Ph.D., reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

CDC/Dr. E. Arum; Dr. N. Jacobs

However, only 1.4 million infections are reported annually, according to information from the CDC, suggests that approximately 400,000 infections go undetected each year.

Adolescent girls – and particularly adolescent non-Hispanic black girls – are at highest risk, according to Dr. Torrone.

The estimated overall prevalence among adolescent girls aged 14-19 years in this study was 6.4%. The estimated prevalence among white girls in this age group was 3.2%, and among black girls in this age group it was 18.6%, reported Dr. Torrone of the division of STD prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, Atlanta.

The overall prevalence was 1.4% among males, 2.0% among females, 2.4% among persons aged 14-19 years, 2.9% among those aged 20-24 years, 1.1% among those aged 25-39 years, 2.3% among Mexican Americans, 5.2% among non-Hispanic blacks, and 0.8% among whites.

Having multiple sex partners in the past year was associated with increased prevalence: 3.2% for those with two or more partners, compared with 1.4% among those with one or no partner.

NHANES respondents included in this analysis were 8,330 adolescents and adults aged 14-39 years between 2007 and 2012 who were tested for C. trachomatis using the Gen-Probe Aptima test. Prevalence estimates were based on demographics and self-reported sexual activity measured through audio, computer-assessed self-interviews.

Estimates were weighted to be nationally representative and to account for oversampling and nonresponse, and the number of infections in the population was estimated by multiplying census estimates by weighted prevalence, Dr. Torrone explained.

Chlamydia is the most commonly reported infection in the United States, and annual screening is currently recommended for all sexually active females under age 25 years, she noted.

Since the findings of this study likely represent an underestimate of the true burden of disease because the estimates do not account for nongenital infection and infections in nonsampled populations where prevalence may be higher (such as incarcerated individuals), they highlight a need for targeted interventions to reduce the impact of chlamydia among young African American women and underscore the importance of adhering to the screening recommendations.

"Health care providers should screen all sexually active young females annually and ensure that all sex partners of patients diagnosed with chlamydia are treated appropriately," Dr. Torrone concluded.

Dr. Torrone reported having no disclosures.

ATLANTA – An estimated 1 in 15 sexually active adolescent girls has a chlamydial infection, and many of these infections go undiagnosed, according to an analysis of National Health and Nutrition Examination Survey data.

According to 2007-2012 NHANES data, the overall prevalence of chlamydia among sexually active adolescents and adults aged 14-39 years is 1.7%, suggesting that there are 1.8 million infections nationally, Elizabeth Torrone, Ph.D., reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

CDC/Dr. E. Arum; Dr. N. Jacobs

However, only 1.4 million infections are reported annually, according to information from the CDC, suggests that approximately 400,000 infections go undetected each year.

Adolescent girls – and particularly adolescent non-Hispanic black girls – are at highest risk, according to Dr. Torrone.

The estimated overall prevalence among adolescent girls aged 14-19 years in this study was 6.4%. The estimated prevalence among white girls in this age group was 3.2%, and among black girls in this age group it was 18.6%, reported Dr. Torrone of the division of STD prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, Atlanta.

The overall prevalence was 1.4% among males, 2.0% among females, 2.4% among persons aged 14-19 years, 2.9% among those aged 20-24 years, 1.1% among those aged 25-39 years, 2.3% among Mexican Americans, 5.2% among non-Hispanic blacks, and 0.8% among whites.

Having multiple sex partners in the past year was associated with increased prevalence: 3.2% for those with two or more partners, compared with 1.4% among those with one or no partner.

NHANES respondents included in this analysis were 8,330 adolescents and adults aged 14-39 years between 2007 and 2012 who were tested for C. trachomatis using the Gen-Probe Aptima test. Prevalence estimates were based on demographics and self-reported sexual activity measured through audio, computer-assessed self-interviews.

Estimates were weighted to be nationally representative and to account for oversampling and nonresponse, and the number of infections in the population was estimated by multiplying census estimates by weighted prevalence, Dr. Torrone explained.

Chlamydia is the most commonly reported infection in the United States, and annual screening is currently recommended for all sexually active females under age 25 years, she noted.

Since the findings of this study likely represent an underestimate of the true burden of disease because the estimates do not account for nongenital infection and infections in nonsampled populations where prevalence may be higher (such as incarcerated individuals), they highlight a need for targeted interventions to reduce the impact of chlamydia among young African American women and underscore the importance of adhering to the screening recommendations.

"Health care providers should screen all sexually active young females annually and ensure that all sex partners of patients diagnosed with chlamydia are treated appropriately," Dr. Torrone concluded.

Dr. Torrone reported having no disclosures.

ATLANTA – An estimated 1 in 15 sexually active adolescent girls has a chlamydial infection, and many of these infections go undiagnosed, according to an analysis of National Health and Nutrition Examination Survey data.

According to 2007-2012 NHANES data, the overall prevalence of chlamydia among sexually active adolescents and adults aged 14-39 years is 1.7%, suggesting that there are 1.8 million infections nationally, Elizabeth Torrone, Ph.D., reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.

CDC/Dr. E. Arum; Dr. N. Jacobs

However, only 1.4 million infections are reported annually, according to information from the CDC, suggests that approximately 400,000 infections go undetected each year.

Adolescent girls – and particularly adolescent non-Hispanic black girls – are at highest risk, according to Dr. Torrone.

The estimated overall prevalence among adolescent girls aged 14-19 years in this study was 6.4%. The estimated prevalence among white girls in this age group was 3.2%, and among black girls in this age group it was 18.6%, reported Dr. Torrone of the division of STD prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, Atlanta.

The overall prevalence was 1.4% among males, 2.0% among females, 2.4% among persons aged 14-19 years, 2.9% among those aged 20-24 years, 1.1% among those aged 25-39 years, 2.3% among Mexican Americans, 5.2% among non-Hispanic blacks, and 0.8% among whites.

Having multiple sex partners in the past year was associated with increased prevalence: 3.2% for those with two or more partners, compared with 1.4% among those with one or no partner.

NHANES respondents included in this analysis were 8,330 adolescents and adults aged 14-39 years between 2007 and 2012 who were tested for C. trachomatis using the Gen-Probe Aptima test. Prevalence estimates were based on demographics and self-reported sexual activity measured through audio, computer-assessed self-interviews.

Estimates were weighted to be nationally representative and to account for oversampling and nonresponse, and the number of infections in the population was estimated by multiplying census estimates by weighted prevalence, Dr. Torrone explained.

Chlamydia is the most commonly reported infection in the United States, and annual screening is currently recommended for all sexually active females under age 25 years, she noted.

Since the findings of this study likely represent an underestimate of the true burden of disease because the estimates do not account for nongenital infection and infections in nonsampled populations where prevalence may be higher (such as incarcerated individuals), they highlight a need for targeted interventions to reduce the impact of chlamydia among young African American women and underscore the importance of adhering to the screening recommendations.

"Health care providers should screen all sexually active young females annually and ensure that all sex partners of patients diagnosed with chlamydia are treated appropriately," Dr. Torrone concluded.

Dr. Torrone reported having no disclosures.