Objective: To determine predictors of Chlamydia trachomatis infection among women 14–24 years of age
attending family planning clinics throughout a rural Midwestern state.
Methods: The study population included 16 756 women between the ages of 14 and 24 years attending family
planning clinics for annual examinations throughout the state of Iowa in 1997. All women under 25 years of age
having annual exams were tested for C. trachomatis during the visit. At the time of exam, both behavioral and
demographic data were collected on all women participating in the study.
Results: The majority of women in the study (96%) reported no symptoms of chlamydia. Only 2.5% of all women
had a positive test result. In the multivariate model, the odds ratios were significantly increased among the youngest
age (14–17 years; OR = 2.2), those with mucopurulent cervicitis (OR = 3.4), cervical friability (OR = 2.2),
symptomatic for infection (OR = 1.8), risk history (OR = 1.6), and black race (OR = 1.2) and predictive of a
C. trachomatis infection.
Conclusions: Risk factors predictive of C. trachomatis infection among younger aged women attending family
planning clinics in a Midwest rural population are consistent with predictors of infection among women attending
family planning clinics across theUnited States. The overall findings suggest the importance of developing screening
guidelines as a means of lowering chlamydia rates. This may be a particularly difficult task in light of the low rate of
symptoms that would lead a woman to seek medical care, even in younger age women who are at higher risk. In
addition, screening guidelines would be more difficult to implement in a rural setting.