Chlamydia and Gonorrhea Testing in Louisiana's Infertility Prevention Project: Before and After Hurricane Katrina

Background:
Since 1996, the Region VI IPP in Louisiana (LA) has been testing and treating men and women for CT and GC at FP and STD clinics. Beginning September 2005, implementation was challenged after Hurricane Katrina.

Objective:
Assess CT/GC testing volume and positivity in New Orleans and surrounding parishes (NOLA) compared to the rest of Louisiana before (January 2004 – June 2005, Time1) and after (January 2006 – June 2007, Time2) Katrina in three populations: female FP clinic clients age <30 years and all male and female STD clinic clients.

Method:
For Time1 and Time2, 199,721 CT/GC tests were analyzed. Eighteen NOLA FP/STD clinics closed or curtailed testing after Katrina. CT/GC trends in testing volume and positivity were calculated for three populations within and outside NOLA.

Result:
Of the 115,235 FP tests, 58% were collected Time1. NOLA was 13% of Time1 tests and 2% Time2. From Time1 to Time2, FP CT+ NOLA: 8.7%, 5.2%; outside NOLA: 7.4%, 6.9%. FP GC+ NOLA: 2.1%, 1.6%; outside NOLA: 1.6%, 1.9%. For 27,804 STD clinic tests, 61% were male; 72% occurred Time1. NOLA STD was 88% of tests Time1 and 57% Time2. From Time1 to Time2: female STD CT+ NOLA: 10.1%, 13.9%; outside NOLA: 10.3%, 10.7%. Male STD CT+ NOLA: 10.8%, 9.4%; outside NOLA: 14.1%, 12.2%. Female STD GC+ NOLA: 6.8%, 10.1%; outside NOLA: 6.6%, 8.2%. Male STD GC+ NOLA: 16.3%, 19.7%; outside NOLA: 12.4%, 19.4%.

Conclusion:
NOLA testing fell significantly after Katrina, but also dropped throughout LA. FP CT+ fell; FP GC+ was low. STD CT+ trends varied by sex and location; STD clinic GC+ increased. Resuming FP/STD clinic services should receive priority after a disaster.

Implications:
Hurricane Katrina affected FP/STD clinics and client populations differentially. Work is needed to identify sub-populations by age, residence or other risks that impact STD testing and positivity.