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Effects of screening and partner notification on Chlamydia positivity in the United States: a modeling study.

Abstract：

OBJECTIVES:Model impact of increasing screening and partner notification (PN) on chlamydia positivity. METHODS:We used a stochastic simulation model describing pair formation and dissolution in an age-structured heterosexual population. The model accounts for steady, casual, and concurrent partnerships and a highly sexually active core group. The model used existing sexual behavior data from the United States and was validated using chlamydia positivity data from Region X (Alaska, Idaho, Oregon, Washington). A screening program with a coverage rate of 20% was implemented among women aged 15 to 24 years. After 10 years, we increased screening coverage to 35%, 50%, and 65% and partner treatment rates from 20% to 40% and 55%. Finally, we included male screening (aged 15-24, screening coverage: 20% and 35%, partner treatment: 25% and 40%). We analyzed the effects on chlamydia positivity in women and the frequency of reinfection 6 months after treatment. RESULTS:The model described the decline in positivity observed from 1988 to 1997 in Region X, given screening coverage of 20% and a 25% partner treatment rate. Increasing screening coverage from 35% to 65% resulted in incremental decreases in positivity as did increasing the PN rate; a 23% reduction in positivity was achieved by either increasing screening by 3-fold or PN by 2-fold. Adding male screening to the program had less impact than increasing screening coverage or PN among women. Increased PN and treatment reduced reinfection rates considerably. CONCLUSIONS:Increasing efforts in PN may contribute at least as much to control of chlamydia infection as increasing screening coverage rates.

journal_name

Sex Transm Dis

journal_title

Sexually transmitted diseases

authors

Kretzschmar M,Satterwhite C,Leichliter J,Berman S

doi

10.1097/OLQ.0b013e31824e52c2

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

325-31

issue

5

eissn

0148-5717

issn

1537-4521

pii

00007435-201205000-00001

journal_volume

39

pub_type

杂志文章

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