Follow up testing among male U.S. Air Force basic trainees diagnosed with chlamydia or gonorrhea, 2017-2023

While female U.S. Air Force and Space Force basic military trainees are screened universally for gonorrhea and chlamydia, male basic trainees are tested only when symptomatic or upon patient request. Epidemiology and follow-up testing of male basic trainees who test positive for gonorrhea or chlamydia in training is unclear. All active duty male basic trainees at Joint Base San Antonio-Lackland who tested positive for gonorrhea or chlamydia from 2017 through 2023 (50 of 182,726 total male trainees, 0.03%) were matched, 1-to-1, by age and accession date, with active duty female basic trainees who tested positive for the same pathogen. Medical records from military hospitals and clinics were reviewed for follow-up testing within 12 months of the initial positive test and subsequent diagnoses for chlamydia and gonorrhea up to 3 years afterwards, or July 1, 2024, whichever occurred first. Among 50 male basic trainees, 30 (60%) reported symptoms when presenting for testing. Most cases (86%) were due to chlamydia. Only 56% (n=28) of male trainees had follow-up testing within 1 year, compared to 76% (n=38) of matched female basic trainees (OR 0.4, 95% CI: 0.17, 0.95). Low screening for chlamydia and gonorrhea among male basic trainees may contribute to reduced follow-up testing and represents a missed opportunity to identify infections, prevent transmission, and reduce the burden of infection in this population. Male basic military trainees who tested positive for gonorrhea or chlamydia had follow-up testing rates significantly below guideline recommendations. Rates of future infections among male basic trainees were not, however, statistically lower than female trainee rates of future infections.