Sexually transmitted diseases like chlamydia, gonorrhea surge in older sexually active women

According to the Centers for Disease Control and Prevention in the US, in 2018, approximately 1,760,000 cases of chlamydia and 583,000 cases of gonorrhea infections were reported. These sexually transmitted diseases are dangerous and early detection is a must for proper treatment and prevention of related health risks.

The rate at which women 18 to 30 years of age tested positive for the two most common reportable sexually transmitted infections grew by double digits between 2010 and 2017, finds an analysis of nearly 18 million de-identified test results from Quest Diagnostics. This study is believed to be one of the largest to examine rates of clinical laboratory test results for Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea) on a national scale. The study examined 17,794,680 co-testing laboratory results for both infections from females aged 12–30 years tested at Quest Diagnostics during 2010–2017. The pre-print version of the study is available in the American Journal of Preventive Medicine (AJPM) online.

Disparity in testing the reason for surge

In addition to showing sharp increases in the positivity rates of chlamydia and gonorrhea, the study also found that the positivity rates of both infections shifted toward older ages over the eight-year study period. This observed shifts in age-based risk is significant because it raises the prospect that current medical guidelines for screening are not aligned with the sexual behaviors of, and associated risk of infection in, women in the United States.

Screening of older women only in high-risk groups

Guidelines from the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend annual screening for both infections in all sexually active women younger than 25 years of age. Screening in women 25 years of age and older is recommended only for those with certain risk factors, such as a new or multiple sexual partners or inconsistent condom use.

Yet, according to the study, the positivity rate for chlamydia for 27-year-old women in 2017 (3.5%) was the same as the positivity rate for 24-year-old women in 2010. A similar dynamic was observed for gonorrhea infections, with the positivity rate in 30-year-olds in 2017 (0.5%) identical to that found in 23-year-olds in 2010. Among the youngest (12-17) age group, the positivity rate declined by 17 per cent for chlamydia and 14 per cent for gonorrhea. Overall, the peak age of positivity for both infections increased by one to two years and, in test results at the farthest distribution, by 3 to 7 years for chlamydia and gonorrhea respectively, over the eight-year study period.

Chlamydia, gonorrhea are symptomless and dangerous

Infections with chlamydia and gonorrhea often lack symptoms and, left untreated, may result in pelvic inflammatory disease and infertility. Researchers say that sexually transmitted infections do not discriminate by age. When such infections go undetected and untreated, the result can be long-term health problems such as infertility and unknowing transmission of the infection to others. Sexual behaviors have changed in the United States, and guidelines need to reflect that women may be spending longer periods of time being sexually active and with more partners prior to childbearing than in the past.

Sexually transmitted diseases like chlamydia, gonorrhea surge in older sexually active women

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Sexually transmitted diseases like chlamydia, gonorrhea surge in older sexually active women

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