Analyzing Chlamydia and Gonorrhea Repeaters and Non-Repeaters in District of Columbia

Background: Sexually transmitted diseases (STDs) continue to have a major impact on the health of DC residents. The liability of STDs falls excessively on the young, poor, minorities and women and STD repeaters form a substantial number of these patients. Post-treatment recurrent infection may result from reinfection and/or resistant infection not cured through the treatment. Repeat infection is associated with an increased risk of reproductive complications, PID, and infertility. Overall the chlamydia repeaters (47.11%) in DC is higher than gonorrhea repeaters (36.92%). The study also analyzes the time to infection for chlamydia and gonorrhea repeaters. 

Methods: As part of the current study statistical analyzes were conducted using STD surveillance data (2000-2013) from HIV/AIDS, Hepatitis, STD, & TB Administration (HAHSTA) within DC Department of Health. Getis and Ord global and local statistics was used to identify the location of the cluster. The study also employs survival analysis to understand the median time to infection in DC for STD patients. 

Results: The global statistics show significant clustering of chlamydia and gonorrhea at 99% (p=<.001) in DC. The hotspots were found statistically significant in the central and southeast DC for gonorrhea and chlamydia, though the number of hotspots is not same. The hotspots have a significant probability of affecting the prevalence of STD in adjacent blocks. The percent of gonorrhea and chlamydia repeaters increased from 2000-2004 to 2005-2009, followed by a marginal decrease between 2010-2013. The median time for chlamydial and gonorrheal repeat reinfection is less than a year in DC.

Conclusions: This research demonstrates that STDs are not equally distributed across geographical regions or among demographic subgroups. This study identifies areas with high prevalence of repeaters who play a significant role in maintaining and spreading STDs. This study is a significant effort towards the effort of STD infection control, effective prevention and intervention strategies.