A retrospective study of recurrent chlamydia infection in men and women: is there a role for targeted screening for those at risk?

Abstract

Chalmydia trachomatis remains the commonest sexually transmitted infection (STI) in the UK. This study identifies those at risk of recurrent infection (RI) attending a central genitourinary clinic, time to subsequent reinfection and duration of at-risk behaviour for the consideration of targeted chlamydia screening. From 1995 to 2005, a total of 14,011 patients' were diagnosed with chlamydia and 1743 (12.4%) had RI, classified as a repeat infection greater than three months after initial diagnosis. Individual risk factors for both sexes include young age <25, two or more partners and failure to attend for test of cure (TOC) and previous STI. Men of non-White ethnicity, symptoms and those self-referred were also at risk. Combined risk factors for both sexes were non-White ethnicity, symptoms, young age, previous STI and two or more partners. Attendance for TOC considerably reduced RI rates in men (odds ratio [OR] = 0.549; 95% confidence interval [CI] 0.359-0.840). Mean time to first and last reinfection in men was 1.91 and 2.49 years, in women 1.76 and 1.92 years. One in eight individuals with chlamydia infection are at risk of RI, the majority of which will occur within two years of initial presentation. These individuals have identifiable risk factors facilitating targeted re-screening, enhanced follow-up and support for behavioural change.

Retesting young STI clinic visitors with urogenitalChlamydia trachomatisinfection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls

“…Having STI-related symptoms and being notified were clear factors associated with reinfection in the current study. This finding concurs with other studies 3 5 10 17 18…”

“…Despite the limitations, this study and other studies conclude that young people with chlamydia are at risk for reinfection and that it is important to retest them and preferably remind them of the retest 3 5 10 17 18. This study has been performed within a standard care environment, complying with the criteria for access to free STI care at STI clinics in the Netherlands, simplifying potential future implementation.…”

The Information–Motivation–Behavioral Skills Model Revisited: A Network-Perspective Structural Equation Model Within a Public Sexually Transmitted Infection Clinic Sample of Hazardous Alcohol Users

“…STI clinic patients, in particular, are in need of additional attention given their inherent elevated risk for infection and repeat infection [3–5]. Individuals with repeated or untreated infections are at greater risk for medical complications including infertility, ectopic pregnancy, and pelvic inflammatory disease [6].…”

Risk Factors for Incident and Redetected Chlamydia trachomatis Infection in Women

“…Identifying risk factors for repeated CT infection is especially important, because women with more than one reported CT infection are at increased risk for reproductive complications. 6 Several prospective studies have investigated risk factors for incident, 7-11 recurrent, 7,8,10,[12][13][14][15][16][17][18][19] or persistent 20,21 CT infection in women. However, several studies suffered from substantial loss to follow-up 7,10,13,15,17 or small sample sizes resulting in low statistical power, especially in analysis of recurrent 7,8 or persistent CT infection.…”