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May 8, 2002

Prevalence of Untreated Sexually Transmitted Disease

JAMA. 2002;287(18):2362-2363. doi:10.1001/jama.287.18.2359

To the Editor: Dr Turner and colleagues1 reported high prevalences of untreated chlamydial and gonococcal infection in a population-based sample in Baltimore, Md. However, they did not mention that Baltimore had the highest incidence of reported gonorrhea among all US metropolitan areas in 1997 and 1998, when the study was conducted, and ranked second and first for the 2 years, respectively, in the incidence of reported chlamydial infection.2 In addition, the authors did not comment on the surprising finding of statistically similar prevalences of the 2 infections. Almost every study during the past 3 decades has shown several-fold higher prevalences of chlamydial than gonococcal infection. Substantial cutbacks in public health clinical services were believed to be partly responsible for resurgent syphilis in Baltimore in the mid-1990s,3 and may have contributed to the high prevalences of gonorrhea or chlamydial infection found by Turner et al. Thus, it is unclear whether these results can be extrapolated to other geographic areas and populations.