Can female adolescents tell whether they will test positive for Chlamydia infection?

OBJECTIVES: Having better predictors of chlamydia infection may improve health care providers' decisions about when to provide testing for Chlamydia trachomatis (Ct). Adolescents' probability judgments of significant life events in the next year and by age 20 y have shown promising validity, being significantly correlated with subsequent self-reports of having experienced these events. Here, the authors examine whether female adolescents' probability judgments of having chlamydia were correlated with the objective outcome of a Ct polymerase chain reaction assay.
METHODS: Three hundred sexually active female adolescents were recruited from urban health care clinics in Pittsburgh. They assessed ''the percent chance that you have chlamydia right now,'' then answered questions about their demographic background and sexual history. Subsequently, the authors tested for Ct infection using a self-administered introital swab.
RESULTS: Adolescents' probability judgments of having chlamydia ''right now'' were correlated with whether they tested positive for Ct infection, even after controlling for demographic variables and sexual history. This result held when probability judgments were dichotomized in terms of whether adolescents had assigned a zero or nonzero probability. Adolescents' mean probability judgment was less than their infection rate, indicating that, on average, they underestimated their actual risk.
CONCLUSIONS: Adolescents can tell whether they are at increased risk for chlamydia but may need better information about its absolute magnitude. Eliciting adolescents' probability judgments of having chlamydia can add value to clinical decision making.