Chlamydia and gonorrhea co-occurrence in a high school population

Background: Chlamydia and gonorrhea coinfection outside of healthcare facilities is less well known. Goal: To determine the co-occurrence of both sexually transmitted diseases (STDs) among high school students participating in a school-based screening and to assess the relevance of dual treatment recommendations in this population. Study Design: During the 1998 to 1999 school year, 5,877 students attending an urban U.S. school district were screened for chlamydia and gonorrhea using urine ligase chain reaction assays. Results: Overall, 451 students had chlamydia, 117 had gonorrhea, including 50 who had both STDs. The gonorrhea and chlamydia co-infections were 50/451 (11.1%) and 50/117 (42.7%), respectively. STD symptoms were reported by 16.0% of students having both infections, 7.7% of those having gonorrhea only, and 5.0% of students having chlamydia only (P = 0.01). Conclusions: The rates of coinfection in this population exceeded those that justify dual treatment in patient-care settings. Chlamydia and gonorrhea co-occurrence may be highly prevalent among certain populations not attending patient-care settings.