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Sex Transm Infect. 2011 Dec;87(7):560-2. doi: 10.1136/sextrans-2011-050185. Epub 2011 Sep 21.

Multiple chlamydia infection among young women: comparing the role of individual- and neighbourhood-level measures of socioeconomic status.

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  • 1Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA.



Young women have the highest burden of chlamydia infections, and socioeconomic disparities exist. Individual-level measures of socioeconomic status (SES) may be difficult to assess for young women. The authors examined whether neighbourhood SES provides a useful measure in comparison with individual-level SES with respect to the burden of multiple chlamydia diagnoses.


In a study of young women with chlamydia (n=233; mean age =21 years), multiple infections were assessed with self-report and follow-up testing. General estimating equations and pseudo-R(2) were used to assess the roles of individual-level SES (education and employment) and neighbourhood-level SES (percentage of people in census tract of residence below poverty) on multiple chlamydia diagnoses.


Neither education nor employment was associated with multiple chlamydia diagnoses. Women living in high-poverty areas were significantly more likely than those living in low-poverty areas to have multiple chlamydia diagnoses (adjusted OR 3.46, 95% CI 1.18 to 10.15). This neighbourhood-level poverty measure improved model fit by 17%.


Neighborhood-level poverty may provide a better measure of SES than individual-level variables as a predictor of multiple chlamydia diagnoses in young women and can be useful when valid measures of individual-level SES are unavailable.

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