Trends in Chlamydia and Gonorrhea Testing and Positivity Rates in a Safety Net Hospital in Georgia: 2014 to 2017

Area of Science:

• Public Health
• Infectious Diseases
• Healthcare Analytics

Background:

• Sexually transmitted infections (STIs), specifically Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC), are rising significantly in the U.S.
• Reported cases of CT and GC have increased by 19% and 56% respectively since 2015.
• Understanding STI testing patterns is crucial for improving care and patient engagement in high-risk urban settings.

Purpose of the Study:

• To analyze STI testing patterns and positivity rates for CT and GC.
• To examine the evolution of CT/GC care over time in a high-risk urban setting.
• To understand how patients utilize healthcare services for STI-related needs.

Main Methods:

• Utilized electronic medical record data from a large safety net hospital in Georgia (2014-2017).
• Extracted patient demographics and clinical characteristics for 124,793 nucleic acid amplification tests.
• Performed descriptive statistics to analyze testing patterns and positivity rates.

Main Results:

• Nucleic acid amplification test volume increased by 12.0% annually from 2014 to 2017.
• Emergency medicine testing volume grew by 45.2%, while primary care volume decreased by 4.3%.
• Highest positivity rates were observed in individuals aged 15-24; CT positivity was higher in females, GC in males, with GC positivity increasing over time.

Conclusions:

• Increased testing volume in emergency medicine necessitates exploring point-of-care testing for improved treatment and antibiotic stewardship.
• High rates of CT/GC among adolescents and young adults indicate a need for tailored care strategies.
• Addressing barriers to care is essential for this vulnerable population to reduce STI transmission.