Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility

Clinical Infectious Diseases, ciz429, https://doi.org/10.1093/cid/ciz429
Published: 24 August 2019

Abstract

Background

We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics.

Methods

This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models.

Results

We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status.

Conclusions

We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

Hyde Street Practice: a service of SHINE SA

SHINE SA, September 2019

Hyde Street Practice is a service of SHINE SA. We offer affordable appointments with friendly and non-judgemental staff.

We are a safe and inclusive practice with general practitioners, specialist services, sexual health and relationship wellbeing services.

Services include:

  • General Practitioners

General GP services, including support for diabetes and cardiovascular health, Pre and post exposure HIV prevention (PEP and PrEP), HIV, hepatitis B and hepatitis C prescribing, STI testing and management

  • Sexual Health Services

SHINE SA sexual health services including contraception, STI testing and management, HIV, PEP & PrEP

  • Sexual Health Physician

A private specialist sexual health and HIV service available by referral

HIV, sexual health, PEP & PrEP, hepatitis C, transgender medicine, LGBTI health

  • Rapido – Rapid HIV Testing

Walk in and Wait service, peer led with results in 20 minutes

  • Psychologist and Counselling

General psychological services and sexual health counselling

  • Gender Wellbeing Service

Professional, peer support and information services for people who are questioning their gender or who identify as trans or gender diverse

  • SAMESH

Support services for gay men, MSM (men who have sex with men), trans men and people living with HIV and people at risk of HIV and STIs, health promotion and education

  • Bobby Goldsmith Foundation

Financial assistance for health related issues to people living with HIV on low incomes

Details:

57 Hyde Street, Adelaide
Call 7099 5320
Monday – Friday 9:00 am – 5:00 pm
Fees available on hydestreet.com.au
To make an appointment visit
www.hydestreet.com.au

or call 7099 5320

Rapido – Rapid HIV Testing
Mondays 3:00 – 6:00 pm
(except Public Holidays)

Sexual Health Service
Walk in and Wait
Fridays 1:00 – 4:00 pm

Clean Needle Program
Monday – Friday 9:00 am – 5:00 pm

Reproductive coercion research – seeking GPs

The University of Melbourne, May 2019

Reproductive coercion (RC) is an under recognised form of abuse experienced by Australian women. RC refers to a group of behaviours that intend to control a woman with regards to reproduction. Contraceptive sabotage, pregnancy coercion and controlling the outcome of a pregnancy are all forms of RC and often occur alongside other forms of abuse in a relationship.

Researchers at the The University of Melbourne are undertaking a project exploring GP’s experiences responding to RC. They aim to understand how GPs identify and respond to this type of abuse. They ask that any antenatal care GPs, or GPs who prescribe medical termination of pregnancy medication to participate in a confidential interview with a member of their team. The interview can be conducted either by telephone or face to face, at a time convenient to your busy schedule. Interviews take approximately 20 minutes and all interview data will be de-identified.

Ethics ID: 1853440.

To register your interest in the project or to gain more information about the project please contact: Molly Wellington

Healthcare providers should discuss U=U with all their HIV-positive patients

aidsmap/nam, 18/03/2019

Healthcare providers should inform all patients with HIV they cannot transmit HIV to a sexual partner when their viral load is undetectable, argue the authors of  a strongly worded comment in The Lancet HIV.

The authors note that despite overwhelming scientific data supporting the undetectable = untransmittable (U=U) message, significant numbers of healthcare providers do not educate their patients about U=U when telling them their viral load is undetectable.

 

 

 

‘Building Workforce Capacity in Sexual Health’ Program: Country South Australia

SHINE SA, March 2019

With rising national rates of sexually transmitted infections (STIs), and in particular chlamydia, gonorrhoea and syphilis, it’s important that SHINE SA support those at the frontline of diagnosis and prevention – general practitioners. SHINE SA has recently been funded by Country SA PHN to deliver a program to support rural and regional health workers.

The Building Workforce Capacity in Sexual Health Program aims to help build capacity and skills around sexual health through education, personalised support and information.

Education and training will be offered in regional areas of South Australia and will focus on addressing the current syphilis outbreak and the ongoing chlamydia epidemic.

RAINING AND EDUCATION OPPORTUNITIES

Through this program SHINE SA will provide opportunities for information, resources, education and training. These opportunities can be both formal and informal depending on needs.

This will include:

  • evening education session/s (see below)
  • webinar and case presentations
  • personalised support including telephone advice
  • information for health practices located in the region
  • increasing access to formal certificate qualifications where relevant

SHINE SA is currently applying for RACGP QI/CPD points for the regional evening education sessions.

REGIONS

This program will reach the following regions:

  • Murray Mallee Region
  • Lower North
  • Mid North & Yorke Peninsula
  • Whyalla
  • Barossa

General practitioners, nurses and/or midwives, Aboriginal Health Practitioners and Aboriginal Health Workers in these regions are encouraged to express interest in receiving training from SHINE SA.

COST

FREE! There is no cost for education and training for those eligible.

TO PARTICIPATE

To express interest in this program please fill out the form here:
Expressions of Interest – Building Workforce Capacity in Sexual Health Program

You can also enrol in the free education sessions:

Sexually Transmitted Infections – Strategies For General Practice
These sessions will give an update of STIs focusing on the current syphilis outbreak and the ongoing chlamydia epidemic.

For any further questions please contact SHINE SA’s Program Lead: Edwina Jachimowicz via email 

COURSE DATES

Murray Bridge – Sexually Transmitted Infections – Strategies for General Practice

Date: 10 April 2019
Time: 6:15pm registration, 6:45 dinner served, 7:00pm-9:00pm
Location:  Adelaide Road Motor Lodge, 212 Adelaide Road, Murray Bridge SA 5253
Status: Open

ENROL NOW

Berri – Sexually Transmitted Infections – Strategies for General Practice

Date: 02 May 2019
Time: 6:15pm registration, 6:45 dinner served, 7:00pm-9:00pm
Location: Berri Hotel,Riverview Drive, Berri SA 5343
Status: Open

Expressions of Interest – Building Workforce Capacity in Sexual Health Program: Country South Australia

Date: 15 June 2019
Status: Open

EXPRESS INTEREST NOW

Update on multi-drug resistant shigella

SHINE SA, 7/3/2019

The shigella outbreak is continuing in South Australia. This is to advise clinicians to be on alert for a potential increase in shigella cases, and to highlight updated recommendations on treatment as released by the Communicable Disease Control Branch (CDCB).

The outbreak is predominantly in men who have sex with men (MSM) and there is a potential for further increase in numbers related to a larger outbreak in Victoria and NSW. We encourage you to be alert for clients who have recently traveled interstate.The CDCB is now recommending that patients with confirmed multi-drug resistant (MDR) shigella (or at risk of MDR shigella while awaiting sensitivities) be treated with five days of Ceftrixaone 1g IV, rather than 1 day (as recommended in the Public Health Alert issued in December 2018).