Patient, staffing and health centre factors associated with annual testing for sexually transmissible infections in remote primary health centres

Sex Health. 2017 Jun;14(3):274-281. doi: 10.1071/SH16123.

Abstract

Background: In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009-10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of re-testing was determined, along with the associated patient, staffing and health centre factors.

Methods: Annual testing was defined as re-testing in 9-15 months (guideline recommendation) and a broader time period of 5-15 months following an initial negative CT/NG test. Random effects logistic regression was used to determine factors associated with re-testing.

Results: Of 10559 individuals aged ≥16 years with an initial negative CT/NG test (median age=25 years), 20.3% had a re-test in 9-15 months (23.6% females vs 15.4% males, P<0.001) and 35.2% in 5-15 months (40.9% females vs 26.5% males, P<0.001). Factors independently associated with re-testing in 9-15 months in both males and females were: younger age (16-19, 20-24 years); and attending a centre that sees predominantly (>90%) Aboriginal people. Additional factors independently associated with re-testing for females were: being aged 25-29 years, attending a centre that used electronic medical records, and for males, attending a health centre that employed Aboriginal health workers and more male staff.

Conclusions: Approximately 20% of people were re-tested within 9-15 months. Re-testing was more common in younger individuals. Findings highlight the importance of recall systems, Aboriginal health workers and male staff to facilitate annual re-testing. Further initiatives may be needed to increase re-testing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Australia / epidemiology
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / ethnology
  • Female
  • Gonorrhea / diagnosis*
  • Gonorrhea / epidemiology
  • Gonorrhea / ethnology
  • Health Services, Indigenous / organization & administration*
  • Humans
  • Male
  • Mass Screening
  • Native Hawaiian or Other Pacific Islander
  • Primary Health Care
  • Sexually Transmitted Diseases / diagnosis*
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / ethnology