부산대학교 도서관

BACKGROUND: During 2010-2017, rates of reported chlamydia decreased among young Black women but increased for White women and all men. Since chlamydia case rates can be influenced by changes in prevalence, screening, and other factors, we compared chlamydia prevalence trends in a sentinel population to national case rate trends to understand potential drivers of case rate trends. METHODS: Chlamydia prevalence was calculated annually among 16-24 year old entrants to the National Job Training Program (NJTP) during 2010-2017. An expectation-maximization-based maximum likelihood approach was used to adjust for misclassification due to imperfect test sensitivity and specificity. Models were stratified by sex, age, and race/ethnicity. A statistically significant trend in prevalence was defined as non-overlapping 95% confidence intervals comparing 2010 and 2017. Trends in chlamydia prevalence were compared to trends in case rates using percentage change over time; relative changes ≥10% were considered meaningful. RESULTS: Among NJTP entrants during 2010-2017, chlamydia prevalence was stable for all Black women, while case rates decreased for adolescents (-12%) and were stable for 20-24 year-olds (-4%). Among adolescent White women, prevalence was stable while case rates increased (+30%). For White women aged 20-24 years, prevalence increased +62% and case rates increased +43%. Trends in prevalence differed from trends in case rates for all subgroups of men. CONCLUSIONS: Prevalence trends in this sentinel population differed from national case rate trends for Black women, White women, and men, suggesting potential decreased screening among Black women 16-19, increased prevalence among White women 20-24, and increased screening among men.