Associated factors with and genotypes of Chlamydia trachomatis infection among clients seeking voluntary counseling and testing for HIV infection in Taiwan

Background/Purpose: This study aimed to investigate the factors associated with Chlamydia trachomatis infection and the genotype distribution of the strains among the clients seeking voluntary counseling and testing (VCT) for human immunodeficiency virus (HIV) in Taiwan. Methods: The VCT clients completed an anonymous self-administered questionnaire interview to inquire into the risks for sexually transmitted diseases, followed by providing a 10-mL first-catch urine specimen to detect C. trachomatis with the use of polymerase-chain-reaction assays. The genotyping of C. trachomatis strains was performed by sequencing of omp1 gene. A case-control study was performed to identify factors associated with chlamydial infection. Results: From 2008 to 2011, 140 (4.2%) of the 3323 VCT clients tested positive for C. trachomatis by polymerase chain reaction assays of urine specimens. Compared with 280 control individuals without C. trachomatis infection, cases were more likely to be female (adjusted odds ratio, 3.28; 95% confidence interval, 1.56-6.90) and to report dysuria or urethral discharge (adjusted odds ratio, 2.57; 95% confidence interval, 1.44-4.61). Infections with genotypes Da and G were significantly more common in male than female individuals (genotype Da, 22.2% vs. 0%; and genotype G, 24.4% vs. 3.3%) and in men who have sex with men than heterosexuals (genotype Da, 22.2% vs. 0%; and genotype G, 24.4% vs. 3.3%). Conclusion: Among the VCT clients in Taiwan, female sex and presence of urethral symptoms were associated with C. trachomatis infection of the genitourinary tract. Homosexual male clients were more likely to be infected with genotypes Da and G than heterosexual clients were. ? 2013, Taiwan Society of Microbiology.