From the Jane Fonda Center, Department of Gynecology and Obstetrics, Emory University School of Medicine.
Rollins School of Public Health, Emory University.
Sex Transm Dis. 2021 Nov 1;48(11):819-822. doi: 10.1097/OLQ.0000000000001439.
The Centers of Disease Control and Prevention guidelines recommend that all patients be retested 3 months after a positive chlamydia (CT) or gonorrhea (GC) result. However, retest rates are generally low, and only a quarter of patients return to clinic for retesting. This analysis explored retesting patterns in a high sexually transmitted infection (STI)/human immunodeficiency virus (HIV)-risk setting to illuminate gaps in adherence to guideline recommendations.
Retrospective chart data from a large urban safety-net institution were analyzed descriptively. Patients who received a positive CT/GC test from January to February 2017 were followed up for at least 4 months to assess if retesting occurred within approximately 3 months.
Our sample of 207 patients was primarily non-Hispanic Black (92.8%), younger than 25 years (63.3%) and women (60.4%). Over half had been initially diagnosed with CT, one-third with GC, and one-tenth with both CT and GC. Eighty-nine (43.0%) patients were retested during the observed period; mean time between tests was 2.7 months. Retesting was most common in infectious diseases/HIV primary care (73.6%) and obstetrics/gynecology (44.9%). Patients who were first diagnosed in emergency medicine were significantly less likely to be retested. Retested patients included a large number of HIV-positive men (31 of 89 total) and pregnant women (23 of 54 women).
Forty-three percent of patients were retested within approximately 3 months of their initial positive CT/GC diagnosis, exceeding previously published rates. Nonetheless, in light of the growing STI epidemic, health care systems should prioritize retesting across high-volume testing specialties, rethink retesting models, and facilitate referrals to ensure that patients receive guideline-recommended, comprehensive STI care.
疾病控制与预防中心的指南建议所有衣原体（CT）或淋病（GC）阳性患者在结果阳性后 3 个月进行复查。然而，复查率普遍较低，只有四分之一的患者返回诊所进行复查。本分析旨在探讨在高性传播感染（STI）/人类免疫缺陷病毒（HIV）风险环境中的复查模式，以阐明在遵守指南建议方面存在的差距。
对一家大型城市综合性医疗机构的回顾性图表数据进行描述性分析。从 2017 年 1 月至 2 月期间，对接受 CT/GC 阳性检测的患者进行至少 4 个月的随访，以评估是否在大约 3 个月内进行了复查。
我们的 207 例患者样本主要为非西班牙裔黑人（92.8%），年龄小于 25 岁（63.3%），女性（60.4%）。超过一半的患者最初被诊断为 CT，三分之一的患者被诊断为 GC，十分之一的患者同时被诊断为 CT 和 GC。在观察期内，有 89 名（43.0%）患者进行了复查；两次检测之间的平均时间为 2.7 个月。在传染病/艾滋病初级保健（73.6%）和妇产科（44.9%）中复查最为常见。在急诊科首次就诊的患者进行复查的可能性显著较低。接受复查的患者中包括大量 HIV 阳性男性（89 例总人数中的 31 例）和孕妇（54 名女性中的 23 例）。
在初始 CT/GC 阳性诊断后大约 3 个月内，43%的患者接受了复查，超过了之前发表的比率。尽管如此，鉴于性传播感染的不断增加，医疗保健系统应优先在高容量检测专科中进行复查，重新考虑复查模式，并促进转介，以确保患者接受指南推荐的全面性传播感染护理。
