What is the Relationship between Being a Young Woman Living in the Urban Area and the Development of Chlamydia Infection?
Interamerican University of Puerto Rico
NURS 3130 Essentials of Nursing Research
Kristi Krieger
Professor Ophelia
February 1, 2013

1. Balfe, M., Brugha, R., O'Donovan, D., O'Connell, E., & Vaughan, D. (2010). Young women"s decisions to accept chlamydia screening: influences of stigma and doctorpatient interactions. BMC Public Health, 10425-435. In this article they are trying to understand the factors that encourage young women to accept, or discourage them from accepting, STI (sexually transmitted infection) testing. Opportunistic screening entails healthcare providers offering Chlamydia testing to people while they are attending health services that are usually not related to their sexual health. They performed a qualitative study that is to investigate, how young women would feel about being offered opportunistic tests for Chlamydia?; how young women would like to be offered screening, and who they wanted to be offered screening by?; and what factors would influence young women's partner notification preferences for Chlamydia. They put together an interview with 35 young women between ages eighteen and twenty nine. This study was performed in the Dublin and Galway regions of the Republic of Ireland. These young adults were asked to join the study from offices of General Practice, Third Level College health services, Family Planning clinics and STI specialist treatment centers. The young women that accepted the screening were concerned that their identity would become stigmatised. The younger women and those from lower social economical environments had the greatest concerns. Most of them indicated that they would allow screening once it was offered to them. Accepting this offer is the most responsible act to engage in. “If an effort is not put into reducing young women's stigma-related concerns the population coverage of Chlamydia screening might be reduced” ( Balfe, Brugha, O'Donovan, O'Connell, & Vaughan, 2010). I think that if an effort is made to reduce the stigma-related concerns, the population coverage of Chlamydia screening can be reduced. 2. Braun, R. A., & Provost, J. M. (2010). Bridging the Gap: Using School-Based Health Services to Improve Chlamydia Screening Among Young Women. American Journal Of Public Health, 100(9), 1624-1629. doi:10.2105/AJPH.2009.186825

In this study, they put into action a Chlamydia screening program that aimed towards young women trying to access reproductive health care services in a school-based setting while also assessing racial/ethnic issues relate to infection. The California Family Health Council joined with 9 health care agencies and 19 educational institutions to start the Educational Partnerships to Increase Chlamydia Screening (EPICS) program from January 2008 through December 2008. EPICS agencies gave reproductive health services to 3396 sexually active females, 85% reported themselves that there was no other source for reproductive health care. Chlamydia screening was provided to 3026 clients and those tested for Chlamydia, 5.6% tested positive. Clients who were African American, Pacific Islander, or Asian were more likely to have a positive test than White clients. Programs that screen for Chlamydia that is in a school-based setting, have the capability to identify and treat a tremendous amount of asymptomatic infection in a population that otherwise may not be reached which can be in an urban area. To make screening easier, school-based clinics should put into action strategies that target the people in the school, and ways to maximize the chance for screening. Being that its school-based, younger women in urban areas will seek that type of screening first because of the programs that are available (privacy). 3. Fine, D., Thomas, K. K., Nakatsukasa-Ono, W., & Marrazzo, J. (2012). Chlamydia Positivity in Women Screened in Family Planning Clinics: Racial/Ethnic Differences and Trends in the Northwest U.S., 1997-2006. Public Health Reports, 127(1), 38-51. In this study they assessed Chlamydia trends, individual-level risk factors, and population-level area-based socioeconomic measures (ABSMs) associated with Chlamydia infection in women attending U.S. Public Health Service, Infertility Prevention Project, and family planning clinics from 1997-2006. They also looked at measures within racial/ethnic subpopulations. They obtained 667,223 Chlamydia tests from women between the ages of 15 and 24 years screened in 201 family planning clinics. They hired a generalized mixed model population and different racial/ethnic subpopulation. Significant racial/ethnic differences in Chlamydia persisted after adjusting for individual and aggregate factors. A relatively steep increase in Chlamydia was found across racial/ethnic ABSM levels. Comparing women over the past ten year period 1997-2006, black woman have always seemed to have a higher infection risk than white women. The impact of population-level ABSMs on Chlamydia varied across racial/ethnic groups and was generally modest. Racial/ethnic differences in Chlamydia persisted over time and were not diminish by adjustment for aggregate socioeconomic position or areal racial/ethnic measures. Changes in the project plan will need to address racial/ethnic disparities for Chlamydia infection among young female family planning clinic clients.

4. Mangin, D., Murdoch, D., Wells, J., Coughlan, E., Bagshaw, S., Corwin, P., & ... Toop, L. (2012). Chlamydia trachomatis Testing Sensitivity in Midstream Compared With First-Void Urine Specimens. Annals Of Family Medicine, 10(1), 50-53. It is very common to use first-void urine specimens to test for Chlamydia trachomatis. Comparing that to mid-stream urine specimens which is usually recommended for microscopy and culture of presumptive bacterial urinary tract infection. In this study, the authors would like to know if testing for Chlamydia trachomatis is as effective in midstream urine specimens testing as it is in first-void urine specimens testing. They used 100 women in this quantitative study which both tested for Chlamydia trachomatis in first-void urine specimens and midstream urine collection. 96% tested positive for Chlamydia trachomatis in the first-void urine specimen, and 95% tested positive in the midstream urine specimen. After doing this research you can now see that timing of the urine specimen collection is not as important when it comes to testing for C trachomatis as previously thought. The sensitivity of newer nucleic acid amplification techniques (NAATs) testing on midstream urine specimens is just as good as first-void specimens and should be considered in clinical practice. Sexually active women are at risk for both urinary tract infections and C trachomatis infection. So therefore, when a woman comes to the clinic for a UTI a quick test for C trachomatis could also be done one time to help the spread of Chlamydia. 5. Gaydos, C., Barnes, M., Aumakhan, B., Quinn, N., Wright, C., Agreda, P., & ... Hogan, T.(2011). Chlamydia trachomatis Age-Specific Prevalence in Women Who Used an Internet-Based Self-screening Program Compared to Women Who Were Screened in Family Planning Clinics. Sexually Transmitted Diseases, 38(2), 74-78.doi:10.1097/OLQ.0b013e3182039d7f In the study the authors intended to determine whether women who do self-collected vaginal swabs at home reveal a higher positivity of Chlamydia trachomatis versus women in family planning clinics. There were collection kits available for vaginal swab screenings which were internet requested, collect specimen at home, and then mailed to a laboratory for testing. They compared age to those from family planning clinics. The median age was 23 years old. Chlamydia positivity was 10.3% for 1171 females mailing swabs compared to family planning with 5.5% (Gaydos, Barnes, Aumakhan, Quinn, Wright, Agreda, & Hogan, 2011). The results were that internet recruited females who got tested had a higher positivity rate over family planning clinics. The internet based screening females usually do not visit clinics for their annual screenings so therefore the positivity rates are higher. 6. Paul, K., Garcia, P., Giesel, A., Holmes, K., & Hitti, J. (2009). Generation C: prevalence of and risk factors for Chlamydia trachomatis among adolescents and young women in Lima, Peru. Journal Of Women's Health (15409996),18(9), 1419-1424. doi:10.1089/jwh.2008.1069 Adolescent and young adult women who live in urban areas with lower social and economic statuses are at a high risk of contracting sexually transmitted infections (STIs). They looked at the association of Chlamydia trachomatis (CT) infection with risk factors of sexually transmitted diseases and partnership-related factors among low-income women by age in Lima, Peru. Within 48 hours after delivery 1290 postpartum women underwent an interview; cervical swabs were collected for CT within 48[pic]h after delivery. The participants’ variables were analyzed in order to evaluate risk factors for Chlamydia trachomatis. Multivariate logistic regression was used to evaluate risk factors for CT, with separate models stratified by age: adolescents (12–19 years), young women (20–24 years), and older women (≥25 years) (Paul, Garcia, Giesel, Holmes, & Hitti, 2009). 7. Schembri, G., & Schober, P. (2011). Risk factors for chlamydial infection in chlamydia contacts: a questionnaire based study. Journal Of Family Planning & Reproductive Health Care, 37(1), 10-16. doi:10.1136/jfprhc.2010.0004 BACKGROUND AND METHODOLOGY: In order to provide satisfactory reproductive health care, individuals with Chlamydia infections as well as their partners require treatment. In order to address this issue treatment is offered before test results are received to the partners of infected individuals. A study was conducted in order to determine any risk factors that predispose partners of individuals infected with Chlamydia. Individuals who entered clinics to get tested were asked to complete questionnaires in regarding to their current sexual partners as well as their prior sexual history. The result of their Chlamydia test was then analysed against those variables. Further research with larger group studies will be necessary to calculate the benefits and risks of alterations to a policy of offering epidemiologic management to high risk contacts only recognized using a projecting model such as the one described here.