Rates of Follow-Up Testing for Chlamydia Trachomatis and Neisseria Gonorrhoeae Among Active-Duty Service Members.

BACKGROUND

Patients who test positive for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) should get retested to evaluate for reinfection. The US military has previously been reported to have high rates of CT and GC, but follow-up rates are unknown. This study evaluates factors associated with follow-up CT or GC testing in active-duty service members (ADSMs).

METHODS

Positive cases of CT and GC among ADSM who were stationed at Joint Base San Antonio between January and June 2023 were evaluated in a retrospective chart review. A patient had follow-up testing if they had a repeat test within 3 to 12 months after their initial positive test result. Follow-up rates were compared among groups based on demographics, clinical setting of testing, and presence of symptoms.

RESULTS

Of the 200 ADSMs who tested positive for CT or GC during the study period, 101 (51%) were men, and the median age was 23 (interquartile range, 20-26). One hundred forty (70%) were junior enlisted (E1-E4). Women received follow-up testing at a higher rate than men (71% vs. 51%; P = 0.003), without significant difference in follow-up testing by clinic, race, service, or organism. Women who were symptomatic at the time of initial test had a significantly higher rate of follow-up testing than did the symptomatic men (76% vs. 49%; P = 0.003).

CONCLUSIONS

Despite standardized follow-up testing recommendations, there were significantly lower follow-up testing rates in men, with the greatest difference in testing in patients who were symptomatic at presentation. Future work should standardize follow-up testing of CT or GC infections in men.