Chlamydia in United States

United States

Chlamydia is a bacterial infection and the most commonly reported sexually transmitted infection (STI) in the United States that can infect both men and women. More than 1.6 million chlamydia cases were reported in 2021. However, the true number of cases is difficult to determine, because people may not seek testing if they do not have symptoms.

Chlamydia infections often have no symptoms, but can still cause permanent damage to reproductive organs. Among women, untreated chlamydia can lead to pelvic inflammatory disease, inability to get pregnant or ectopic pregnancy, a life-threatening condition in which the fertilized egg develops outside the uterus. Untreated chlamydia in men rarely causes life-threatening damage but can cause painful testicular swelling (epididymitis).

Chlamydia infections cost the U.S. $691 million in direct medical costs in 2018. Lifetime medical costs per infection are estimated at approximately $46 for men and $262 for women.

Social conditions such as poverty, low educational attainment and unemployment can present barriers to accessing quality sexual health care. Living without consistent STI screening and medical care can lead to higher rates of chlamydia and untreated chlamydia.

According to America’s Health Rankings, populations with higher rates of chlamydia include:

• Females, who are more likely to be diagnosed with chlamydia than males, due in part to routine screening and higher frequency of symptoms. 
• Black, American Indian/Alaska Native and Native Hawaiian Pacific Islander populations, compared with Hispanic, multiracial, white and Asian populations.

Other populations with higher rates of chlamydia include:

• Youth ages 15-24 compared with older age groups.

Effective prevention and treatment strategies can combat the spread of chlamydia. While abstinence is the only completely effective prevention strategy, having a single sexual partner, reducing the number of sex partners and making sure to use latex condoms and/or dental dams properly during sex may reduce transmission. 

Screening can prevent the development of pelvic inflammatory disease and other conditions from untreated chlamydia. Providers should integrate screening for chlamydia and other STIs into regular medical care. Annual screening is recommended by the Centers for Disease Control and Prevention (CDC) for:

• Sexually active and/or pregnant women younger than 25.
• Sexually active and/or pregnant women ages 25 and older with a new partner, multiple partners or a partner who tested positive for an STI.

The CDC recommends routine screening for men only in high prevalence settings or in populations that have a high burden of infection, such as men who have sex with men. 

Once diagnosed, chlamydia is easily treated with antibiotics combined with a short period of abstinence from sex. Expedited partner therapy is available in some states and allows providers to prescribe antibiotics for sexual partners of individuals diagnosed with chlamydia, which has been shown to prevent reinfection.

Healthy People 2030 has an objective to increase the proportion of sexually active female adolescents and young women who get screened for chlamydia. Additionally, The U.S. Department of Health and Human Services has developed an STI National Strategic Plan with detailed approaches, goals and progress-tracking indicators to address the STI epidemic and reduce STI-related health disparities.

Gable, Jennifer, Jennifer Eder, and Cynthia Mollen. “Preventing Chlamydia and Gonorrhea Reinfection through Increased Use of Expedited Partner Therapy.” Evidence to Action Brief. Philadelphia: PolicyLab at CHOP Research Institute, December 2016. https://policylab.chop.edu/sites/default/files/pdf/publications/Preventing_Chlamydia_Gonorrhea_Reinfection_through_Increased_Use_of_EPT.pdf.

Kumar, Sagar, Harrell W. Chesson, Ian H. Spicknall, Kristen M. Kreisel, and Thomas L. Gift. “The Estimated Lifetime Medical Cost of Chlamydia, Gonorrhea, and Trichomoniasis in the United States, 2018.” Sexually Transmitted Diseases 48, no. 4 (April 2021): 238–46. https://doi.org/10.1097/OLQ.0000000000001357.

Owusu-Edusei, Kwame Jr., Harrell W. Chesson, Thomas L. Gift, Guoyu Tao, Reena Mahajan, Marie Cheryl Bañez Ocfemia, and Charlotte K. Kent. “The Estimated Direct Medical Cost of Selected Sexually Transmitted Infections in the United States, 2008.” Sexually Transmitted Diseases 40, no. 3 (March 2013): 197–201. https://doi.org/10.1097/OLQ.0b013e318285c6d2.

Trent, Maria, Breanne Das, and Jocelyn Ronda. “Pelvic Inflammatory Disease: Improving Awareness, Prevention, and Treatment.” Infection and Drug Resistance Volume 9 (August 2016): 191–97. https://doi.org/10.2147/IDR.S91260.