Prospective screening for sexually transmitted infections among US service members with Chlamydia trachomatis or Neisseria gonorrhoeae infection

PLoS One. 2023 Jan 20;18(1):e0280783. doi: 10.1371/journal.pone.0280783. eCollection 2023.

Abstract

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most common bacterial causes of sexually transmitted infection (STI) in the United States (US). The purpose of this study was to determine the frequency of reinfection during a six-month study period and to evaluate the retesting interval for those infected with CT or NG.

Methods: We conducted a prospective, six-month follow-up study among US military personnel with new onset, laboratory-confirmed CT or NG, recruited from an STI clinic at a large military base from January 2018 to January 2020. Each participant was randomly assigned to one of four groups, which differed only by the timing of the first study-associated follow-up visit after CT or NG diagnosis.

Results: Of the 347 initially recruited into the study, 267 participants completed a follow-up visit prior to their scheduled, final visit 6 months after initial infection. The median age at enrollment was 22 years and 41.0% were female. There were 32 (12.0%) reinfections (30 CT and 2 NG) after treatment of an index diagnosis of CT or NG within the six-month study period. Six of the CT reinfections were only detected at the final visit. A review of medical records revealed additional CT and NG reinfections. The probability of detecting a reinfection did not vary significantly by timing of follow-up.

Conclusions: The likelihood of detecting CT or NG reinfection did not differ according to time of follow up visit among study participants, thus supporting CDC guidance to retest three months post treatment. Efforts should continue to focus on STI prevention and risk reduction.

Publication types

  • Review
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chlamydia Infections* / diagnosis
  • Chlamydia Infections* / epidemiology
  • Chlamydia Infections* / prevention & control
  • Chlamydia trachomatis
  • Female
  • Follow-Up Studies
  • Gonorrhea* / diagnosis
  • Gonorrhea* / epidemiology
  • Gonorrhea* / prevention & control
  • Humans
  • Male
  • Neisseria gonorrhoeae
  • Prevalence
  • Prospective Studies
  • Reinfection
  • Sexually Transmitted Diseases* / prevention & control
  • United States / epidemiology

Grants and funding

This work was supported by the US Army Medical Research and Development Command under Contract Numbers W81XWH-16-C-0225, W81XWH-16-C-0337 and by cooperative agreements (W81XWH-11-2-0174, W81XWH-18-2-0040) between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), and the US Department of Defense. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.