National Clinician Scholars Program, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
J Adolesc Health. 2022 Nov;71(5):545-551. doi: 10.1016/j.jadohealth.2022.06.014. Epub 2022 Aug 11.
Chlamydia trachomatis/Neisseria gonorrhea (CT/NG) retesting three months after diagnosis is a guideline-recommended strategy to detect re-infections. Adolescents and young adults are priority populations in the U.S. Sexually Transmitted Infections National Strategic Plan, but there is a lack of research examining CT/NG retesting among these populations. This study describes retesting following CT/NG diagnosis among adolescent and young adult patients at Title X and non-Title X clinics and measures the association of patient-level factors with CT/NG retesting.
We evaluated electronic medical records from 2014 to 2020 from an academic urban-suburban primary care network. The primary outcome was retesting, defined as a diagnostic test for CT or NG ordered 8-16 weeks after index diagnosis. Mixed effects logistic regression modeling stratified by Title X funding was conducted to evaluate the association of patient-level factors with CT/NT retesting.
Overall, 23.5% (n = 731) of patients were retested within 8-16 weeks following index CT/NG diagnosis. A significantly greater proportion of Title X patients were retested compared to non-Title X patients. Males were significantly less likely to be retested compared to females, and the proportion of patients retested decreased significantly over the study period.
Guideline-recommended retesting following CT/NG diagnosis was low in this young primary care cohort, especially among male and non-Title X clinic patients. Decreases in CT/NG retesting over the study period may be contributing to worsening of the STI epidemic. Our results provide insights into CT/NG retesting that can inform efforts to end the STI epidemic.
根据指南建议，在诊断出沙眼衣原体/淋病奈瑟菌（CT/NG）后三个月进行复查，是检测再感染的一种策略。在美国，性传播感染国家战略计划将青少年和年轻成年人作为重点人群，但缺乏针对这些人群的 CT/NG 复查研究。本研究描述了在 X 标题和非 X 标题诊所中，青少年和年轻成年患者在诊断出 CT/NG 后的复查情况，并衡量了患者因素与 CT/NG 复查之间的关系。
我们评估了来自一个学术性城市郊区初级保健网络的 2014 年至 2020 年的电子病历。主要结果是复查，定义为在指数诊断后 8-16 周内为 CT 或 NG 进行的诊断性检查。采用分层 X 标题资金的混合效应逻辑回归模型评估患者因素与 CT/NT 复查之间的关联。
总体而言，23.5%（n=731）的患者在指数 CT/NG 诊断后 8-16 周内进行了复查。与非 X 标题患者相比，X 标题患者的复查比例明显更高。与女性相比，男性进行复查的可能性明显较小，而且随着研究时间的推移，进行复查的患者比例显著下降。
在这个年轻的初级保健队列中，特别是在男性和非 X 标题诊所患者中，遵循指南建议在诊断出 CT/NG 后进行复查的比例较低。在研究期间，CT/NG 复查的减少可能导致性传播感染的流行情况恶化。我们的研究结果提供了有关 CT/NG 复查的见解，可以为结束性传播感染流行提供参考。
