Table 1 Seven hypotheses for increasing Chlamydia rates modified from "Epidemiology of Chlamydia infection: are we losing ground? Rekart ML, Brunham RC, 84; 87-91, copyright 2008" [4] with permission from BMJ Publishing Group, Ltd.

H1.

More false positive tests because NAAT* methods have lower specificity than culture methods.

H2.

NAAT testing results in increased case detection due to better sensitivity than non-NAAT methods.

H3.

NAAT testing of urine is less invasive and more acceptable, particularly among men, resulting in higher testing rates.

H4.

NAAT methods allow for self-collected specimens and targeted screening among persons at high risk.

H5.

Decreased chlamydial susceptibility to antimicrobials.

H6.

Increased rates of unsafe sexual practices.

H7.

Arrested immunity resulting from treatment with antimicrobials.