Purpose

Chlamydia trachomatis/Neisseria gonorrhea (CT/NG) retesting three months after diagnosis is a guideline-recommended strategy to detect re-infections. Adolescents and young adults are priority populations in the U.S. Sexually Transmitted Infections National Strategic Plan, but there is a lack of research examining CT/NG retesting among these populations. This study describes retesting following CT/NG diagnosis among adolescent and young adult patients at Title X and non-Title X clinics and measures the association of patient-level factors with CT/NG retesting.

Methods

We evaluated electronic medical records from 2014 to 2020 from an academic urban-suburban primary care network. The primary outcome was retesting, defined as a diagnostic test for CT or NG ordered 8–16 weeks after index diagnosis. Mixed effects logistic regression modeling stratified by Title X funding was conducted to evaluate the association of patient-level factors with CT/NT retesting.

Results

Overall, 23.5% (n = 731) of patients were retested within 8–16 weeks following index CT/NG diagnosis. A significantly greater proportion of Title X patients were retested compared to non-Title X patients. Males were significantly less likely to be retested compared to females, and the proportion of patients retested decreased significantly over the study period.

Discussion

Guideline-recommended retesting following CT/NG diagnosis was low in this young primary care cohort, especially among male and non-Title X clinic patients. Decreases in CT/NG retesting over the study period may be contributing to worsening of the STI epidemic. Our results provide insights into CT/NG retesting that can inform efforts to end the STI epidemic.

中文翻译：

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初级保健网络中青少年和年轻人的沙眼衣原体/淋病奈瑟氏菌重新检测

 目的

诊断后三个月重新检测沙眼衣原体/淋病奈瑟菌 (CT/NG) 是指南推荐的检测再次感染的策略。青少年和青壮年是美国性传播感染国家战略计划的重点人群，但缺乏对这些人群进行 CT/NG 复检的研究。本研究描述了 Title X 和非 Title X 诊所的青少年和年轻成年患者 CT/NG 诊断后的重新测试，并测量了患者层面因素与 CT/NG 重新测试的关联。

 方法

我们评估了 2014 年至 2020 年学术城郊初级保健网络的电子病历。主要结果是重新检测，定义为在指数诊断后 8-16 周进行的 CT 或 NG 诊断检测。采用 Title X 资助分层的混合效应逻辑回归模型来评估患者层面因素与 CT/NT 重新测试的关联。

 结果

总体而言，23.5% (n = 731) 的患者在 CT/NG 诊断后 8-16 周内接受了重新检测。与非 Title X 患者相比，Title X 患者接受重新检测的比例明显更高。与女性相比，男性接受重新检测的可能性明显较低，并且在研究期间接受重新检测的患者比例显着下降。

 讨论

在这个年轻的初级保健队列中，指南建议的 CT/NG 诊断后重新检测的比例较低，特别是在男性和非 Title X 诊所患者中。研究期间 CT/NG 重新检测的减少可能导致性传播感染流行的恶化。我们的结果提供了对 CT/NG 重新检测的见解，可以为结束性传播感染流行的努力提供信息。