Correlates of sexually transmitted infections in young women [letter]

The well-designed study by Boyer et al. of predictors of sexually transmitted infections in young women is a useful contribution that should help guide prevention strategies. However its value is compromised by the decision to display only the combined outcome for 3 infections. Despite the obvious similarities in anatomic sites of infection and mode of transmission the epidemiological characteristics and determinants of chlamydial infection gonorrhea and trichomoniasis are quite different--dramatically so in some settings. With prevalences of 12.2% 2.1% and 1.7% respectively the reported correlates probably are valid for Chlamydia trachomatis infection but perhaps not for the others. At the same time the determinants of chlamydial infection are diluted by the inclusion of gonorrhea and trichomoniasis. The authors should provide the multivariate associations for chlamydial infection (e.g. a modification of their table 2) and should summarize the correlates found for gonorrhea and trichomoniasis. (excerpt)