Background:
The federal recommendation to re-screen women three to four months after treatment for Chlamydia was based on several studies employing a variety of methods to encourage client return.

Objective:
To assess the feasibility and effectiveness of combining multiple methods of encouraging client return on the re-screening rate of women with Chlamydia.

Method:
A prospective cross-sectional study of 15-24 year-old women attending nine Infertility Prevention Project (IPP) STD clinics and testing positive for Chlamydia from September 1 to February 28, 2006. Following informed consent, all enrollees were offered an incentive, and asked to indicate their preference for a reminder to return; M1) mail M2) telephone or M3) no reminder (unassisted). Those who returned were given a $15 gift card. Those who did not were followed-up with an additional phone call, unless the third option was chosen.

Result:
Of 1347 screened, 179 (13.3%) were infected and 70 (39%) gave informed consent. Thus far, 48 women were scheduled for re-screening. They were reminded to return using their selected method (M1=35; M2=8; M3=5). Six (12.5%) returned at the appointed time (M1=2; M2=3; M3=1). Supplemental telephone reminders were made to 27 non-returnees (M1 or M2), which resulted in an additional 7 returns, bringing the overall return rate to 27%. Of the 13 women who have returned for re-screening, only 1 (7.7%) was found to be reinfected. Data collection for re-screening is ongoing.

Conclusion:
Preliminary results indicate that a combined incentive and reminder method has not substantially enhanced return rates compared with the single option methods shown in the literature.

Implications:
The re-screening of women with Chlamydia may be difficult to implement at the clinic level, and further methods need to be developed to enhance the practicality of this recommendation.