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

Area of Science:

• Public Health
• Infectious Diseases
• Military Health

Background:

• Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infections require follow-up testing to prevent reinfection.
• Previous reports indicate high CT and GC rates in the US military, but follow-up testing rates remain unquantified.
• This study investigates factors influencing follow-up CT or GC testing among active-duty service members (ADSMs).

Purpose of the Study:

• To evaluate the rates of follow-up testing for CT or GC infections in ADSMs.
• To identify demographic and clinical factors associated with follow-up testing adherence.
• To compare follow-up testing rates between genders and symptomatic status.

Main Methods:

• A retrospective chart review was conducted on ADSMs stationed at Joint Base San Antonio from January to June 2023.
• Follow-up testing was defined as a repeat test within 3 to 12 months post-initial positive result for CT or GC.
• Rates were compared based on demographics, clinical setting, and symptom presence.

Main Results:

• Of 200 ADSMs with positive CT/GC tests, 51% were male, with a median age of 23.
• Women showed significantly higher follow-up testing rates (71%) than men (51%; P = 0.003).
• Symptomatic women had higher follow-up rates than symptomatic men (76% vs. 49%; P = 0.003).

Conclusions:

• Standardized recommendations for follow-up testing are not equally effective for all ADSMs.
• Men, particularly those symptomatic at initial diagnosis, exhibit significantly lower follow-up testing rates for CT/GC.
• Future research should focus on standardizing and improving follow-up testing strategies for CT/GC infections in male service members.