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

BACKGROUND: Patients who test positive for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) should get retested to evaluate for reinfection. The United States military has previously been reported to have high rates of CT and GC, but follow-up rates are unknown. This study evaluates factors associated with follow-up CT or GC testing in active-duty service members (ADSM).

METHODS: Positive cases of CT and GC among ADSM who were stationed at Joint Base San Antonio between January and June 2023 were evaluated in a retrospective chart review. A patient had follow-up testing if they had a repeat test within 3-12 months after their initial positive test. Follow-up rates were compared among groups based on demographics, clinical setting of testing, and presence of symptoms.

RESULTS: Of the 200 ADSM who tested positive for CT or GC during the study period, 101 (51%) were men, and the median age was 23 [IQR: 20-26]. 140 (70%) were junior enlisted (E1-E4). Women received follow-up testing at a higher rate than men (71% vs. 51%; p = 0.003), without significant difference in follow-up testing by clinic, race, service, or organism. Women who were symptomatic at time of initial test had a significantly higher rate of follow-up testing than symptomatic men (76% vs. 49%; p = 0.003).

CONCLUSIONS: Despite standardized follow-up testing recommendations, there were significantly lower follow-up testing rates in men, with the greatest difference in testing in patients who were symptomatic at presentation. Future work should standardize follow-up testing of CT or GC infections in men.