Risk factors for recurrent Chlamydia trachomatis infections in women.

Objective: We evaluated risk factors for recurrent Chlamydia trachomatis infections in women.

Study Design: We used a retrospective cohort design to examine predictors of recurrent infection in the 38,866 female residents of Wisconsin whose first reported C. trachomatis infection occurred between 1985 and 1989.

Results: Young age at first reported infection was the strongest predictor of recurrent C. trachomatis infection, after adjustment for covariates. Adolescents < 15 years old had an eightfold increased risk, those 15 to 19 years old had a fivefold increased risk, and women 20 to 29 years old had a twofold increased risk of recurrent C. trachomatis infection, compared with that among women 30 to 44 years old. In 54% of those aged < 15 at initial infection and 30% of those aged 15 to 19, recurrence developed. Other characteristics associated with recurrence included black race, residence in Milwaukee County, coinfection with gonorrhea, and past sexually transmitted diseases; receiving care in a family-planning clinic appeared protective.

Conclusions: Implementation of strategies to reduce the markedly elevated risk of recurrent chlamydia infections is urgently needed in female adolescents.