Chlamydia - Women in California

California

The vast majority of reported chlamydia cases in the United States occur in women, particularly women of reproductive age. In 2022, more than half of all reported chlamydia cases occurred in adolescents and young adults ages 15-24.

Chlamydia is a commonly reported sexually transmitted infection (STI) in the U.S., and has been steadily increasing over the last decade. Although this trend appears to have reversed in 2020, the Centers for Disease Control and Prevention (CDC) cautions that COVID-19-related decreases in health care use and STI screenings likely led to the underdiagnosis of chlamydial infections. 

While chlamydial infection usually has no noticeable symptoms, it can cause permanent damage to reproductive organs if left untreated. Among women, untreated chlamydia can lead to pelvic inflammatory disease, infertility, ectopic pregnancy (pregnancy outside the uterus) and chronic pelvic pain. Further, chlamydial infection in pregnant women can result in negative health outcomes for the baby, including premature birth and conjunctivitis (pink eye).

Social conditions such as poverty, low educational attainment and unemployment can present barriers to accessing quality sexual health care and contribute to higher rates of chlamydia. 

Reported chlamydia cases are higher among:

• Black women, who have a rate nearly 12 times higher than Asian women. American Indian/Alaska Native and Hawaiian/Pacific Islander women also have high rates, while white, multiracial and Hispanic women also have low rates.
• Women ages 15-24 compared with women age 25 and older.

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 or reducing the number of sexual partners and making sure to use latex condoms and dental dams properly can reduce transmission. Screening for and discussing STI status with sexual partners are critical to stopping the spread of chlamydia, and screening may prevent complications of chlamydial infection among high-risk women. The CDC recommends regular chlamydia screening for:

• Sexually active women younger than age 25.
• Sexually active women age 25 and older who have a new partner, multiple partners or a partner with a positive STI screening.
• Pregnant women at their first prenatal visit and during the third trimester.

If diagnosed, chlamydia is curable with antibiotics combined with abstinence during the antibiotic course. Expedited partner therapy is available in some states and allows providers to prescribe antibiotics for sexual partners of individuals diagnosed with chlamydia, which prevents reinfection.

Healthy People 2030 has an objective to increase the proportion of sexually active female adolescents and young women who get screened for chlamydia.

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.

Gao, Rui, Buyun Liu, Wenhan Yang, Yuxiao Wu, Bo Wang, Mark K. Santillan, Kelli Ryckman, Donna A. Santillan, and Wei Bao. “Association of Maternal Sexually Transmitted Infections With Risk of Preterm Birth in the United States.” JAMA Network Open 4, no. 11 (November 29, 2021): e2133413. https://doi.org/10.1001/jamanetworkopen.2021.33413.