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The efficacy of azithromycin vs. doxycycline for urogenital Chlamydia trachomatis infection was assessed in this randomized clinical trial. In a directly observed treatment context, the efficacy of azithromycin was 97% and that of doxycycline was 100%. Urogenital Chlamydia trachomatis infection is the most prevalent bacterial sexually transmitted infection in the United States and worldwide. 1 , 2 Females are disproportionately affected by this infection because of the risk of pelvic inflammatory disease, which can lead to ectopic pregnancy and infertility. Efforts to prevent and control chlamydia infection, which have been aimed mainly toward the reduction of sequelae, have not diminished the high prevalence. Along with screening, the provision of effective treatment is a cornerstone of chlamydia control programs. For the treatment of chlamydia infection, the Centers for Disease Control and Prevention (CDC) recommends oral administration of either 1 . . .

African American adolescent males have disproportionately high rates of morbidity and mortality and low levels of primary care use. To optimize health care for this group, there is a need to understand their views on doctors and health care, reasons for foregone care, and preferences regarding provision of health care. This was a pilot survey of African American adolescent males attending community groups in Chicago. A majority of respondents agreed with declarative statements about doctors being considerate, truthful, and respectful (63%, 80%, and 80%, respectively). A majority also indicated that the health care system informs them of ways to stay healthy (65%), but fewer agreed that it meets the needs of adolescents and minorities (44% and 33%, respectively). Race/gender concordance with physicians did not seem to be a high priority. Significant reasons for foregone care included conflict with school hours, parents not having time, and lack of transportation. Despite access issues, only a minority of participants wanted health care services co-located with other aspects of their daily lives (school, community centers, church, and barbershops). African American adolescent males may view doctors and the health care system positively. Eliminating barriers to care and ensuring positive interactions may create opportunities to improve health issues afflicting these at-risk adolescents.

To the Editor: Within the community of providers who treat sexually transmitted infections, there has been concern that azithromycin may be less effective than doxycycline in treating Chlamydia trachomatis infection. Geisler et al. (Dec. 24 issue) 1 report on their trial comparing these two drugs, and in an accompanying editorial, Quinn and Gaydos 2 discuss the problem of treatment for these genital tract infections. Yet, neither the article nor the editorial mentions the treatment of extragenital infections. Such infections are not rare. Testing men who have sex with men for rectal and oropharyngeal C. trachomatis infection, as compared with testing for urethral . . .