DADI.org

The researchers conducted urine-based testing for chlamydia among 23,010 female Army recruits between January 1996 and June 1999. The recruits also answered questions about sexual history, presence or absence of symptoms, and prior history of sexually transmitted diseases.

The findings underscore the need for routine testing of female Army recruits to protect their health, says study author Charlotte Gaydos, an associate professor of medicine at the Johns Hopkins University School of Medicine. The Army doesn't screen new recruits for the disease, but the Navy and Marines do, she adds.

"These rates are of great concern," Gaydos says. The incidence of chlamydia also provides "clear justification," she says, for screening of women entering the Army, treatment when necessary and periodic re-screening.

Chlamydia can be detected by a simple urine test and is cured easily with antibiotics. But the disease often goes unnoticed because most women who get it show no symptoms and screening is not routine, Gaydos says.

In fact, about 75 percent of American women and 50 percent of men with chlamydia have no symptoms, so they're unaware of their infections and therefore may not seek care, the U.S. Centers for Disease Control and Prevention (news - web sites) (CDC) has found.

"It's been called the silent disease; it just doesn't produce symptoms for the most part," Gaydos says.

The Hopkins researchers cite statistics showing 3 million to 4 million Americans are infected with chlamydia each year.

Chlamydia can cause pelvic inflammatory disease in women that can lead to scarring, infertility, tubal pregnancy and chronic pelvic pain. The CDC estimated in 2001 that up to 40 percent of women with untreated chlamydia would get pelvic inflammatory disease, and of those with the pelvic disease, 18 percent would have debilitating, chronic pelvic pain, and 9 percent, a life-threatening tubal pregnancy.

Gaydos says the study results also demonstrate the need for more chlamydia screening among the general population.

"Programs for screening and treating chlamydia infection have proven to be cost-effective, especially when compared to the health problems associated with untreated infections," she says.

The researchers found several factors associated with infection, including age (under 25), southern U.S. hometowns, more than one sex partner and a history of other sexually transmitted diseases.

Overall, 9.5 percent of the Army recruits tested positive for chlamydia, but the rate increased from 8.5 percent at the start of the study to 9.9 percent at the end, the researchers say.

Dr. Kimberly Yarnall, an associate clinical professor in the department of community and family medicine at Duke University Medical Center, says young women should ask to be tested for chlamydia.

But Yarnall says many sexually active young women mistakenly believe they're not at risk for sexually transmitted diseases, including chlamydia.

"There's a huge disconnect here. They're not getting the fact that they are at risk, and they're not taking measures to protect themselves," Yarnall says.

She points to a study published in the August issue of Preventive Medicine. Yarnall and other researchers surveyed 1,210 women -- students and non-students between 18 and 25 -- and found 61 percent of non-students and 56 percent of students had unprotected sex within the past three months.

Yet, more than three-quarters of all the women surveyed believed they were at low risk for contracting a sexually transmitted disease in the next year.

Awareness about sexually transmitted diseases has declined in recent years, Yarnall says. "I think people get lulled into thinking, 'Oh, it's not going to be a problem, or I'm not going to get it, or it's easily curable,'" she says.

Gaydos says more public awareness would lead to more chlamydia screening.

"If we had more public-awareness campaigns," she says, "we'd have more women and men going in and saying, 'I'm sexually active, can I be screened?"

More information

For more on chlamydia, visit the National Institute of Allergy and Infectious Diseases or the U.S. Centers for Disease Control and Prevention.