Using Regional Prevalence Monitoring Data to Evaluate Chlamydia Rescreening and Reinfection Rates At Infertility Prevention Project (IPP) Screening Sites

Background: The CDC recommends that Chlamydia-infected women and men should be retested approximately 3 months after treatment. If retesting at 3 months is not possible, clinicians should retest in the 12 months following initial treatment.

Objectives: 1) Determine if regional IPP chlamydia prevalence monitoring data can be used to evaluate rescreening/reinfection rates; 2) Identify baseline rescreening/reinfection rates regionally (HHS Region V), by state (Midwest), client demographics and screening site type.

Methods: Region V states agreed to provide a unique client ID for chlamydia and gonorrhea data submitted quarterly to the Region V IPP using a concatenation of client name and DOB masked to protect confidentiality. By September 2011, data was available to evaluate rescreening and reinfection rates for four of six Region V states (IL, OH, MN, WI) for persons testing positive for chlamydia between July – December 2009.

Results: Rescreening rates among females after initial positive test was 26.4% within 31-180 days and 36.7% within 31-364 days with an overall reinfection rate of 10.0% compared to rescreening rates among males of 14.3% and 21.6%, respectively for comparable time periods and an overall reinfection rate of 8.0%. Females 15 - 25 years of age had the highest rescreening rates, 26.9% and 37.4% for the two time periods and the highest reinfection rate, 10.7%. African Americans had the highest rescreening (39.4%) and reinfection (12.1%) rates between 31-364 days. School Based and Adolescent/Teen clinics had the highest reinfection rates, 21.4% and 15.9%, respectively.

Conclusions: Chlamydia rescreening and reinfection rates can be determined using IPP prevalence monitoring data and the rates vary greatly by state, client demographics and screening site type.

Implications for Programs, Policy, and Research: Programs should collect and evaluate data on Chlamydia rescreening and reinfection rates to improve program performance in identifying and treating persons re-infected within 12 months of treatment.