To Re-Test or Not to Re-Test? Findings from the English National Chlamydia Screening Programme Consultation on Routine Re-Testing Following a Chlamydia Diagnosis

Background: Young adults who test positive for chlamydia are at increased risk of subsequent infection. The English National Chlamydia Screening Programme (NCSP) recommends that sexually active under-25 year olds are tested for chlamydia annually or on change of sexual partner. In 2012-13 the NCSP carried out a consultation on whether individuals diagnosed with chlamydia should be routinely offered a re-test around three months after treatment. 

Methods: Existing models of service delivery were identified using telephone interviews with a convenience sample of service providers (n=19). Views of professionals and young adults were obtained using a web-based questionnaire, expert meeting and focus group. Baseline re-testing rates (the proportion of diagnoses where another test was recorded within 7-14 weeks) among 15 to 24 year olds were calculated for each local authority for January to March 2013 using routinely collected data on all chlamydia tests in England. 

Results: Chlamydia re-testing practices varied from no routine re-testing to the mailing of home sampling kits. Health professionals and young adults were supportive of introducing re-testing following a chlamydia diagnosis. Both groups emphasised that the offer of a re-test should be part of case management and does not replace the need for partner notification or advice on safer sex. In October to December 2012 re-testing rates ranged from 0%–31% (IQR: 7%–17%) for tests in community settings and 0%–50% (IQR: 6%–14%) in genitourinary medicine clinics.

Conclusions: Following this consultation, the NCSP updated their recommendations for case management to include a routine offer of a re-test around three months after treatment. Local areas will be provided with a suite of guidance to support local decision-making and tools for enhanced data collection to investigate reasons for repeat diagnoses. Post-implementation re-testing rates will be presented and compared to baseline rates to explore the impact of the recommendation.