Repeat Gonococcal and Chlamydial Infections Among STD Clinic Clients – Chicago 2002-2006

Background:
Reported gonorrhea cases have declined since 2002. From 2002 to 2006, reported chlamydia fluctuated, impacted by the closing of certain screening programs.

Objective:
To characterize STD clients who have repeat gonococcal or chlamydial (GC/CT) infections over a five-year period.

Method:
Medical records from 2002 –2006 from municipal STD clinics were analyzed to identify GC/CT cases. “Repeaters” were defined as persons with two or more infections within 31 days, and “non-repeaters” were persons with one GC/CT episode within the study period.

Result:
Among the six municipal STD clinics, 96,698 clients made 171,894 visits from 2002 to 2006. Among these clients, 3% (2,960/96,698) were repeaters with GC/CT infections and 23% (22,598/96,698) were non-repeaters. The median time between infections was 254 days (range 31-1672) for GC repeaters and 314 days (range 31-1719) for CT repeaters. Among GC repeaters 87% were male, 96% were non-Hispanic black (NHB) and the median age was 23 years. Of GC non-repeaters 72% were male, 92% were NHB and the median age was 24 years. Comparing CT repeaters, 69% were male, 92% were NHB and the median age was 21 years. Of CT non-repeaters 63% were male, 84% were NHB and the median age was 23 years. Among GC infections, males were 2.7 times more likely to be repeaters than non-repeaters (OR=2.7, CI=2.3 to 3.1). Of CT infections, males were 1.3 times more likely to be repeaters than non-repeaters (OR=1.3, CI=1.1 to 1.4).

Conclusion:
Young minority males were more likely to have repeat GC/CT infections. The interval between repeat gonococcal infections was shorter than for repeat chlamydial infections.

Implications:
Identifying the populations with repeat GC/CT infections to target prevention interventions to reach core transmitter networks.