The chlamydia infection rate has been rising unabated.
While rates of some STIs have fluctuated over the past 40 to 80 years, chlamydia rates have increased progressively since the first reporting data became available in 1984, says Matthew M. Hamill, MBChB, PhD, MPH, MSc, assistant professor of medicine at Johns Hopkins University School of Medicine. In 1990, the rate of chlamydia was 170 per 100,000 population.1
“That rate now is greater than 500 per 100,000 population,” Hamill notes. “Since chlamydia has been reported, the rates have increased progressively with each year and, certainly, with each decade.”1,2
Most people with chlamydia do not know they are infected. It can infect the genital tract, the pharynx or back of the throat, and rectum.
“People can have symptoms with chlamydia, but these are uncommon — and particularly uncommon in throats and the rectum,” Hamill explains.
It is unlikely the rising chlamydia rate is due primarily to improved screening. “There is better awareness around chlamydia, and the CDC guidelines say that all women, under age 25, who are sexually active, should be screened on an annual basis,” Hamill says. “But in more recent years, there hasn’t been any change in screening recommendations, and the technology hasn’t changed.”
In women, the most recent rate of chlamydia is 700 cases per 100,000 population.2 Women may assume they are screened for the STI during their annual gynecological check-up, but that might not happen.
“Many providers will screen, but unless they take a sexual history of patients, opportunities for screening have been missed,” Hamill explains.
Rates of chlamydia depend on where a person lives because some areas and some populations have a higher prevalence. For instance, the highest rate of chlamydia is in Alaska, which has a case rate of 848 per 100,000 population.3
Women who have sex with women and those who use sex toys also could be at risk. “It’s theoretically possible that STIs can be transmitted that way,” Hamill says.
REFERENCES
- Webster LA, Greenspan JR, Nakashima AK, Johnson RE. An evaluation of surveillance for chlamydia trachomatis infections in the United States, 1987-1991. MMWR CDC Surveill Summ 1993;42:21-27.
- Centers for Disease Control and Prevention. Chlamydia statistics. Updated April 5, 2021.
- Centers for Disease Control and Prevention. Table 2. Chlamydia – reported cases and rates of reported cases by state, ranked by rates, United States, 2019. Updated April 13, 2021.
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