Chlamydia - Women

Chlamydia - Women in United States

United States

The vast majority of chlamydia cases in the United States are in women, particularly women of reproductive age. In 2020, the highest reported rate of chlamydia cases was in adults ages 20-24 and was twice as high for women compared with the rate for men in the same age group.

Chlamydia is caused by the bacterium Chlamydia trachomatis and is the most commonly reported sexually transmitted infection (STI) in the United States. The rate of reported chlamydia cases has been steadily rising over the past few decades. However, the rate of reported cases decreased in 2020. The Centers for Disease Control and Prevention (CDC) cites the COVID-19 pandemic as the likely reason for this decrease in reported cases, due partly to resource limitations, social distancing measures and decreased screening rates.

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, an inability to get pregnant, 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 delivery, low birthweight, conjunctivitis infection (pink eye) and pneumonia.

Because chlamydia is one of the most common STIs, it is also one of the most costly. The lifetime medical treatment costs for chlamydia in the United States are estimated at over $500 million, with an estimated lifetime cost of $364 per case among women.

Social conditions such as poverty, low educational attainment and unemployment can present barriers to accessing quality sexual health care and lead to higher rates of chlamydia. Rates of reported cases of chlamydia were higher among:

• Black, American Indian/Alaska Native and Native Hawaiian/Pacific Islander women compared with Hispanic, multiracial, white and Asian women.
• Women ages 20-24, followed by women ages 15-19, compared with women ages 25 and older

While abstinence is the only completely effective prevention strategy, mutual monogamy, reducing the number of sexual partners and proper use of latex condoms and/or dental dams 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 chlamydia infection among high-risk women. The CDC recommends regular screening for chlamydia for:

• Sexually active women younger than age 25.
• Sexually active women ages 25 and older with 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 easily cured 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 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.

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

Owusu-Edusei, Kwame Jr., Harrell W. Chesson, Thomas L. Gift, Guoyu Tao, Reena Mahajan, Marie Cheryl Bañez Ocfemia, and Charlotte K. Kent. 2013. “The Estimated Direct Medical Cost of Selected Sexually Transmitted Infections in the United States, 2008.” Sexually Transmitted Diseases 40 (3): 197–201. https://doi.org/10.1097/OLQ.0b013e318285c6d2.