The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Wednesday, March 12, 2008
P138

Re-testing for Chlamydia trachomatis Infection in Massachusetts Family Planning Clinics

Marie Ellen Caggiano, Department of Family Medicine and Community Health, University of Massachusetts Medical School, 119 Belmont St, Jaquith 2, Worcester, MA, USA, William Dumas, Division of STD Prevention, Massachusetts Department of Public Health, Boston, MA, USA, Thomas Bertrand, State Laboratory Institute, Massachusetts Dept. of Health, 305 South Street, Room 560, Jamaica Plain, MA, USA, Katherine Hsu, Sylvie Ratelle STD/HIV Prevention Training Center of NE, Massachusetts Department of Public Health, State Lab Institute, 305 South Street, Room 560A, Jamaica Plain, MA, USA, and Sylvie Ratelle, STD Division, Massachusetts Department of Public Health, State Laboratory Institute, 305 South Street, Boston, MA, USA.


Background:
Because a high prevalence of chlamydia re-infection has been observed in women following treatment for chlamydia infection, the CDC has recommended re-testing of all women approximately 3 months after treatment for chlamydia infection. Little is known about factors influencing a woman's return for re-testing.

Objective:
To examine factors associated with chlamydia re-testing after treatment for chlamydia infection.

Method:
A case was defined by first positive chlamydia test in a woman seen between 1/1/05-12/31/05 at one of 8 Massachusetts family planning organizations. Data available for review included age at diagnosis, clinic organization, race/ethnicity, and history of prior chlamydia infection. Multivariate logistic regression was performed to identify factors associated with chlamydia retesting 3-<12 months after the initial positive test.

Result:
Of 402 chlamydia cases in women identified during the study period, 116 (29%) had re-testing within 3-<12 months; 29 (25%) were diagnosed with repeat infection. In cases <=18 years old, 43/104 (41%) were re-tested, versus 73/297 (25%) in cases >18 years old. The two clinic organizations handling highest number of chlamydia infections re-tested 62/161 (39%), versus 9/56 (16%) in two clinic organizations with lowest number. Younger age (OR 1.8, 95% CI 1.1-3.0) and highest number (OR 3.3, CI 1.3-10.0) were associated with retesting in a logistic regression model including age, race/ethnicity, clinic organization, and prior history of chlamydia infection. No significant associations with re-testing were found with race/ethnicity or prior history of chlamydia infection.

Conclusion:
Repeat chlamydia infection was common in women re-tested for chlamydia 3-<12 months after incident chlamydia infection. Younger age and certain clinic organizations were associated with greater chlamydia re-testing amongst women seen at Massachusetts family planning organizations.

Implications:
Given how common chlamydia re-infection appears to be, more study is needed to identify factors that influence chlamydia re-testing rates.

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