Region I Infertility Prevention Project
Epidemiology and Statistics

National Data

Selected data from the Centers for Disease Control and Prevention's  "Sexually Transmitted Disease Surveillance 2002 Supplement: Chlamydia Prevalence Monitoring Project Annual Report 2002", October 2003:

  • In 2002, 834,555 chlamydial infections were reported to the CDC from 50 states and the District of Columbia.

  • From 1987 through 2002, the reported rate of chlamydial infection among women increased from 78.5 cases per 100,000 population to 455.4 cases per 100,000 population.  These increases likely represent increased screening, increased use of nucleic acid amplification tests that are more sensitive than other types of screening tests, improved reporting, and the continuing high burden of disease.

  • In 2002, the median state-specific chlamydia test positivity among 15- to 24-year-old women screened in family planning clinics was 5.6% (range, 3.0% to 14.2%).

  • In 2002, after adjusting trends in chlamydia positivity to account for changes in laboratory test methods and associated increases in test sensitivity, chlamydia test positivity decreased in six of 10 Health and Human Service Regions (1, 2, 3, 4, 6 & 9) from 2001-2002 and increased in four Regions (5, 7, 8, & 10).  Although chlamydia positivity has declined in the past year in some regions due to the effectiveness of screening and treatment of women, continued expansion of screening programs to populations with higher disease prevalence may have contributed to the increase in positivity in other regions.

  • In 2002, the median state-specific chlamydia test positivity among 15- to 24-year-old women screened in selected prenatal clinics in 26 states and the Virgin Islands was 7.4% (range, 1.5% to 14.4%).

  • Among women entering the National Job training Program in 2002, based on their place of residence before program entry, state-specific chlamydia prevalence ranged from 4.4% to 16.8% in 28 states and Puerto Rico.  The median state-specific chlamydia prevalence was 10.1%.

  • Data on positivity of chlamydial infection among women entering juvenile or adult corrections facilities were reported to CDC from 28 states.  Among women entering juvenile facilities in 2002, chlamydia prevalence ranged from 6.3% to 28.3%, and among those entering 17 adult facilities, prevalence ranged from 0.8% to 14.5%.
  • In 2002, chlamydia positivity among 15- to 30-year-old women screened at clinics in three Indian Health Service regions ranged from 7.4% to 9.7%.


For more detailed information, see the Centers for Disease Control and Prevention website: http://www.cdc.gov/std

To view the CDC chlamydia fact sheet go to: http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm

To view the full "Sexually Transmitted Disease Surveillance 2002" report go to: http://www.cdc.gov/nchstp/dstd/Stats_Trends/Stats_and_Trends.htm

Click to View the 2002 Chlamydia Prevalence Monitoring Project Annual Report

Tracking the Hidden Epidemics, Trends in STDs in the United States 2000 - Published in 2000, this document tracks trends through 1999 surveillance data. (Corrected April 6,2001)

Other Downloadable files:

Syphilis Surveillance Supplement 2002

Regional Data
Regional Trends

The following tables show chlamydia positivity trends over time for Region I.  Overall, the total number clinic sites participating in the project and the total number of female family planning clients tested at these sites have increased from 21 sites and 7,300 clients tested in 1996, to 166 sites and 68,098 tested in 2004. For states screening all women under the age of 25 in family planning clinics, the percent of female family planning clients testing positive was 4.4% positive in 1996 and 4.3% positive in 2004, though with slight decreases and increases in positivity in the meantime. In Massachusetts, formerly conducting universal screening but screening women under the age of 30 since mid 2002, the percent of females testing positive increased from 3.3% in 1997 to 4.4% in 2004.

Chlamydia screening and testing continues to occur in other settings including STD clinics, county jails, youth detention facilities, and school-based clinics. Tables 2-7 describe chlamydia positivity and total tested in other clinic settings for 2004, and table 8 shows other clinics testing by gender in 2004.

Four states in Region I are currently performing dual testing for chlamydia and gonorrhea.  Table 9 lists gonorrhea testing data for 2004. For 2004, overall positivity for GC was low with 60/9795 or 0.6% in Connecticut testing positive for GC, 17/8016 tested positive in New Hampshire or 0.2%, 3/3455 tested positive in Maine or 0.1%, and 27/10302 or 0.3% tested positive in Vermont.  In Connecticut, 48% of those testing positive for GC were also positive for Chlamydia, and in Vermont 41% of those testing positive for GC were also positive for Chlamydia, and in New Hampshire there was a 29% co-infection rate in 2004.

Despite some increases and decreases between 1996 and 2004, positivity remained about the same among females in the 10-14 year old age group, (5.8% in 1996 to 6.0% in 2004), in the 15-19 year old age group (6.2% in 1996 to 4.7% in 2004), and in the 20-24 year old age group (4.4% in 1996 to 4.4% in 2004.  

The number of male partners being tested through the project has increased from 222 tested in 1996, to 1530 tested in 2000, and 3101 tested in 2004. Two of the states (Connecticut and Massachusetts), accounted for 83% of the men tested through the project in 2004. Overall in 2004, 11.7% (362/3101) of the men tested positive compared to 3.8% (1894/49,538) of female clients testing positive. Males had a higher percent positive for all age groups between 10-29. 

 

Family Planning Screening Criteria and Test Technologies, Region I Infertility Prevention Project, 1996-2004

 

Connecticut: Selective screening <20 in 1996, 1997, Jan - June 1998. Change in selective screening criteria to <25 in July 1998. Chlamydia project family planning clients only - uninsured and underinsured. Increased from 8 to 12 family planning sites in 2001. Connecticut added 2 new juvenile detention center sites in 2002, and one additional juvenile detention site in 2003. Have used BD Strand Displacement test since July 2001 (previously used GenProbe).

 

Maine: Selective screening criteria <20 1996 - 1998. Change in selective screening criteria < 25 in 1999. Data include Chlamydia project family planning clients - uninsured or underinsured, and data on clients with other payment sources in clinics that receive IPP funds. Increase in number of sites – 5 sites in 1996, 14 sites in 1997, 19 sites in 1998, 26 family planning sites in 2000. As of January 2004, Maine also has 3 STD clinics, 1 juvenile detention center clinic, and 8 high school health centers reporting to project. Switched to Aptima II assay test on July 16, 2002 (previously used GenProbe II).

 

Massachusetts: Conducted universal screening 1996 through mid-2002. Testing for 1996 includes quarter 3 and quarter 4 only. Switched to selective screening, <30 in June 2002. Data include Chlamydia project-funded clients, and data on clients with other payment sources in clinics that receive IPP funds. As of August 2004, Massachusetts has 23 family planning sites, 13 STD clinics, 24 high school health centers, 4 jails, 7 youth detention centers, 4 drop-in centers and 5 other clinics reporting to project. Switched to BD ProbeTec on February 10, 2003 (previously used Abbott LCx test).

 

New Hampshire: Change in regional plan from 1996 to 1997- following regional screening criteria in 1997. Data from 1996 testing limited to symptomatic clients and their partners; selective screening < 20 in 1997 and 1998; <25 in 2001. Collects data on all clients in project-funded clinics who meet screening criteria regardless of payment source. Increase from 8 to 9 family planning sites in 2001 and to 10 in 2002. As of January 2004, New Hampshire has 16 family planning sites, 1 youth detention center and 1 other clinic reporting to project. Use BD Strand Displacement Test.

 

Rhode Island: Began screening third Quarter 1998. Selective screening criteria < 25. Collects data on all clients in project-funded clinics who meet screening criteria regardless of payment source. Increase from 5 to 7 family planning sites in 2002. As of January 2004, Rhode Island has 7 family planning sites, 1 STD clinic, and 2 high school health centers reporting to project. Switched to Aptima II on September 3, 2002 (previously used Abbott LCx).

 

Vermont: Selective screening < 20 in 1996 and 1997. Change in selective screening criteria to <25 in July 1998. Collects data on all clients meeting screening criteria regardless of payment source. Data includes all clients in project-funded clinics, both insured and uninsured clients, since Quarter 2 1997. Increased number of sites performing testing in 1998 from 2 sites to 13 sites. Vermont added an additional family planning site in 2004 bringing the total number of clinics to 14 reporting to the project. Switched to Aptima II assay test on June 1, 2002 (previously used GenProbe II).

 

Cumulative 2004 Data 

Table 1: Number Tested and Percent Positive at Family Planning Clinics by State and Year  

 

1996

1997

1998

1999

2000

 2001 2002 2003 2004
  # tested  % pos.  (sites) # tested  % pos.  (sites) # tested  % pos.  (sites) # tested  % pos.  (sites) # tested  % pos.  (sites) # tested  % pos.  (sites) # tested  % pos.  (sites) # tested  % pos.  (sites) # tested  % pos.  (sites)
Connecticut

Maine

Massachusetts

New Hampshire

Rhode Island

Vermont

4524   4.6%   (5)

1167   3.8%   (5)

945   3.8%   (4)

46   23.9%   (5)

---

609   2.5%   (2)

3327   4.2%   (4)

1930   2.3%   (14)

3491   3.3%   (4)

832   4.6%   (5)

---

764   3.3%   (2)

3253   3.8%   (4)

3035   2.3%   (19)

3364   4.7%   (8)

1005   5.6%   (5)

561   2.1%   (5)

3812   2.0%   (13)

4335   2.9%   (5)

5448   2.8%   (25)

4897   3.1%   (12)

1124   6.0%   (5)

702   7.4%   (5)

7207   2.1%   (13)

7033   3.8%   (8)

3915   3.5%   (26)

7205   4.2   (15)

1320   4.4%   (5)

386   8.3%   (5)

7081   2.1%   (13)

 9128  4.1%  (12)

5603  3.4%  (26)

7277  4.4%  (17)

1960  5.9%  (9)

1132  6.4%  (7)

7973 2.9% (13)

 10724  4.8%  (12)

6996  4.3%  (26)

8554  5.4%  (17)

2756  4.3%  (17)

3183  5.2%  (8)

8394 4.2% (13)

 9495  4.9%  (12)

6803  4.6%  (26)

9959  4.1%  (17)

8240  4.4%  (17)

4530  4.0%  (8)

8393 4.0% (13)

 9796  5.2%  (12)

4593  4.5%  (25)

11754  4.4%  (27)

11670  4.0%  (16)

4527  4.2%  (7)

10303 3.6% (14)

Note: Selective screening >25 in CT, ME, NH, RI, VT.  MA conducted universal screening until June 2002 when they switched to selective screening <30.
Table 2: State Data by Number of STD Clinics, Total Number of Clients Tested and Percent Positive, 2004
QUARTER 1-4, 2004
State

 Number of STD Clinics
n		 Total Tested1
n		 Positive
n %
Maine 3 669 95 14.2%
Massachusetts 7 6138 529 8.6%
Rhode Island 1 574 97 16.9%
TOTAL 11 7381 721 9.8%
1 Total Tested includes valid chlamydia test results (indeterminate and missing CT test results are excluded).
Table 3: State High School Health Center Data by Total Number of Clients Tested and Percent Positive, 2004
Quarter 1-4, 2004
State
 High School Health Centers
n		 Total Tested1
n		 Positive
n %
Maine 7 196 7 3.6%
Massachusetts 24 914 62 6.8%
Rhode Island 2 153 20 13.1%
TOTAL 33 1263 89 7.0%
1 Total Tested includes valid chlamydia test results (indeterminate and missing CT test results are excluded).
Table 4: State Jail Clinic Data by Total Clients Tested and Percent Positive, 2004
Quarter 1-4, 2004
State
 Jail Clinics
n		 Total Tested1
n		 Positive
n %
Massachusetts 4 3992 255 6.4%
TOTAL 4 3992 255 6.4%

1 Total Tested includes valid chlamydia test results (indeterminate and missing CT test results are excluded).

 
Table 5: State DYS Clinic Data by Total Clients Tested and Percent Positive, 2004
Quarter 1-4, 2004
State
 DYS Clinics
n		 Total Tested1
n		 Positive
n %
Connecticut 3 857 53 6.2%
Maine 2 100 5 5.0%
Massachusetts 6 1364 97 7.1%
New Hampshire 1 59 2 3.4%
Vermont 1 25 0 0.0%
TOTAL 13 2405 157 6.5%
1 Total Tested includes valid chlamydia test results (indeterminate and missing CT test results are excluded).
Table 6: State Drop-in Clinic Data by Total Clients Tested and Percent Positive, 2004
Quarter 1-4, 2004
State
 Drop-in Clinics1
n		 Total Tested2
n		 Positive
n %
Massachusetts 1 20 1 5.0%
TOTAL 1 20 1 5.0%
1 Drop-in clinics are out-patient clinics where no appointment is necessary. The patient may or may not be self-referred.  Also known as walk-in clinics.
2 Total Tested includes valid chlamydia test results (indeterminate and missing CT test results are excluded).
Table 7: State Other Clinic Data by Total Clients Tested and Percent Positive, 2004
Quarter 1-4, 2004
State
 Other Clinics1
n		 Total Tested2
n		 Positive
n %
Massachusetts 1 61 7 11.5%
New Hampshire 1 338 20 5.9%
TOTAL 2 399 27 6.8%
1 Other clinics include a homeless shelter, and AIDS Service Organization, a pediatric medical group, a pediatric study and a teen health clinic located in a primary care setting.

2 Total Tested includes valid chlamydia test results (indeterminate and missing CT test results are excluded).
Table 8: Clinic Types by Total Tested and Percent Positive by Gender, 2004

Quarter 1-4, 2004
  Females Males
Clinic Type Total Tests No. Positive Percent Positive Total Tests No. Positive Percent Positive
FP - CT 8854 371 4.2% 942 138 14.6%
FP - ME 4470 174 3.9% 123 34 27.6%
FP - MA 11377 473 4.2% 377 40 10.6%
FP - NH 10920 388 3.6% 746 78 10.5%
FP - RI 4443 178 4.0% 84 10 11.9%
FP - VT 9474 310 3.3% 829 62 7.5%
 
STD Clinics ME 515 34 6.6% 154 61 39.6%
STD Clinics MA 2042 153 7.5% 4096 376 9.2%
STD Clinics RI 574 97 16.9% 0 0 0.0%
 
High School ME 184 7 3.8% 12 0 0.0%
High School MA 716 50 7.0% 198 12 6.1%
High School RI 144 20 13.9% 9 0 0.0%
 
Jail MA 1267 59 4.7% 2724 196 7.2%
 
DYS*  CT 252 31 12.3% 605 22 3.6%
DYS*  ME 100 5 5.0% 0 0 0.0%
DYS*  MA 363 44 12.1% 1001 53 5.3%
DYS*  NH 33 1 3.0% 26 1 3.8%
DYS*  VT 7 0 0.0% 18 0 0.0%
 
Drop-in MA 20 1 5.0% 0 0 0.0%
 
Other MA 36 4 11.1% 25 3 12.0%
Other NH 263 14 5.3% 75 6 8.0%
 

           * DYS: Department of Youth Services.

 

Table 9: Gonorrhea Testing Data, 2004

State

Total Tests

No. GC Positive

Percent GC Positive

No. Positive GC and CT

Co-Infection (% of GC also positive for CT)

Connecticut

 9795 60 0.6% 29

29/60 =48%

New Hampshire

 8016 17 0.2% 5

5/17=29%

Maine

 3455 3 0.1% 0

0/3=0%

Vermont

 10302 27 0.3% 11

11/27=41%


Table 10:Total Number of Clients Tested/Percent Positive in Family Planning Clinics, By Gender and Year

 
 

FEMALES

MALES

Total Tested

Total Positive

% Positive

Total Tested

Total Positive

% Positive

1996*

6356

278

4.4%

222

38

17.1%

1997**

10,387

364

3.5%

286

34

11.9%

1998

15,141

497

3.3%

447

46

10.3%

1999

23,713

703

3.0%

863

55

6.3%

2000

26,941

947

3.5%

1530

175

11.4%
2001 31,503 1152 3.7% 1546 148 9.6%
2002 38074 1578 4.1% 2525 337 13.3%
2003 44803 1732 3.9% 2599 340 13.1%
2004 49538 1894 3.8% 3101 362 11.7%

*represents data from 4 states (excludes MA and RI)

** represents data from 5 states (excludes RI)

 

 

Table 11:Total Number of Clients Tested/Percent Positive in Family Planning Clinics in States Performing Selective Screening <25 (CT, ME, NH, RI, VT) by Age Group and Gender, 2004
 

FEMALES

MALES
 

Total Tested

% Total Tested

Total Positive

% Positive

Total Tested

% Total Tested

Total Positive

% Positive

Total Tested

 38161 91.1%

1421

3.7%

2724

 6.5%

322

11.8%
                 

Age

                

< 10

 1

0

0.0%

 0   0

0.0%

10-14

 349   21 6.0% 11   2 18.2%

15-19

 12360   584 4.7% 557   58 10.4%

20-24

 14228   600 4.2% 1184   176 14.9%

25-29

 5461   149 2.7% 497   67 13.5%

30-39

 4024   54 1.3% 305   16 5.2%

40-49

 1420   12 0.8% 128   3 2.3%

>50

 302   1 0.3% 41   0 0.0%

Missing/Unknown

 16   0 0.0% 1   0 0.0%


 


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