Prevalence of concurrent STIs with Chlamydia

Chlamydia trachomatis is the most common sexually transmitted infection (STI) diagnosed in NHS genitourinary medicine (GUM) clinics in the United Kingdom. The highest rates of Chlamydia Treatment are among 16-19 year old females and 20-24 year old males. Co-infections with other STIs are common. National chlamydia screening programme involves the opportunistic screening of the target group in non-GU settings and further referral of all chlamydia positive patients to GU medicine for a full STI screening.

Genital Chlamydia trachomatis infection is the most common sexually transmitted infection (STI) diagnosed in NHS GUM clinics within the UK. Untreated chlamydia can cause significant morbidity with nearly 20% of infected women developing pelvic inflammatory disease (PID). We examine a study that aims to assess the prevalence and significance of other STIs (e.g. Gonorrhoea) associated with Chlamydia Treatment.

Results: There were 429 males and 373 females in the index group and 439 males and 399 females in the control group. The women's age group ranged from 15-56 years with a mean age of 22.6 years and for men it ranged from 16-39 years with a mean age of 20.3 years. Those with two or more partners within the last 12 months had more risk of Chlamydia than those with a new partner in the last 3 months. Infection with Gonorrhoea, genital warts, Herpes Treatment, and genital herpes was more common in Chlamydia positive men compared to Chlamydia negative men.

For women, as was observed for the men, patients with multiple partners had more risk of Chlamydia than those with new partners. Gonorrhoea, genital warts and genital herpes infections were found more commonly in women with Chlamydia compared with controls, as were bacterial vaginosis.

The number of Chlamydia diagnoses in the Uk has risen steadily over the past decade with the latest figures showing a rise of 8% between 2010 and 2011 – an increase of 12% in males and 6% of females. Other STIs have shown a similar trend. Rates of Gonorrhoea, the second most common bacterial STI in the UK has increased in all age groups since 1995 with the sharpest increases in males aged 20 to 24 years and females’ ages 16 to 19 years. Long term complications from Gonorrhoea in both men and women are similar to those of untreated Chlamydia infections. In women PID, ectopic pregnancy and infertility are the commonest serious sequelae from both conditions.

The National Chlamydia Screening Programme (NCSP), targeting men and women under the age of 25 attending healthcare facilities not traditionally associated with providing specialist sexual health services, has now been operational for nearly a decade. The majority of patients screened for Chlamydia Treatment and who tested positive were asymptomatic. In both men and women the prevalence of both gonorrhoea and genital warts was found to be significantly greater in those with Chlamydia . The risk of having a co-infection may also depend on factors such as geographical distribution, social deprivation and ethnicity. Discussing sexual health in primary care settings may be uncomfortable for staff and patients. A recent study showed that there is a lack of knowledge about Chlamydia testing at non GUM clinic settings.
Thus there is a risk of co-infections with Chlamydia. All individuals testing positive for Chlamydia should be strongly encouraged to have a full STU screening.