Comparison of Self-Reported and Test-Identified Chlamydial Infections among Young Adults in the United States of America

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Citation

Iritani, Bonita J.; Ford, Carol A.; Miller, William C.; Hallfors, Denise Dion; & Halpern, Carolyn Tucker (2006). Comparison of Self-Reported and Test-Identified Chlamydial Infections among Young Adults in the United States of America. Sexual Health, 3(4), 245-251.

Abstract

Background: Many studies rely on respondent reports of prior diagnosed sexually transmissible infections (STIs), but these self reports are likely to under-estimate infection prevalence. The extent of bias from using self-reported STI data, and whether bias varies by sex and race, is largely unknown. This gap is addressed using a large, nationally representative sample.
Methods: Cross-sectional analyses of Wave III of the National Longitudinal Study of Adolescent Health. Participants were 18–26 years old (n = 12 359). Estimates of the prevalence of chlamydial infection based on self-reported diagnoses in the past year were compared with actual prevalence based on nucleic acid amplification testing (NAAT) at the time of data collection. Ratios of test-identified prevalence to self-reported diagnosis prevalence were calculated by sex and race/ethnicity groups. Larger ratios indicate greater extent of self reports under-estimating infection prevalence.
Results: About 4.2% of the sample had a current NAAT-identified chlamydial infection, but only 3.0% reported having been diagnosed with chlamydia in the past year, yielding a ratio of 1.43. The ratio of test-identified infection prevalence to prevalence identified from self-reported diagnoses was larger among men than women (2.07 versus 1.14, P < 0.05). Among men, the ratio was larger among non-Hispanic blacks (2.40) compared with non-Hispanic whites (1.07, P < 0.05).
Conclusions: Use of self-reported diagnoses under-estimates chlamydial infection prevalence, particularly among men, and among non-Hispanic black men. Reliance on self-reported STIs may consequently lead to biased conclusions, particularly for these groups. Use of biological testing for STIs in research studies is recommended.

URL

http://dx.doi.org/10.1071/SH06040

Reference Type

Journal Article

Year Published

2006

Journal Title

Sexual Health

Author(s)

Iritani, Bonita J.
Ford, Carol A.
Miller, William C.
Hallfors, Denise Dion
Halpern, Carolyn Tucker

ORCiD

Halpern - 0000-0003-4278-5646