207493 Managing chlamydia infections in young men: Findings from a chart review of a public men's clinic serving a low income population in New York City

Monday, November 9, 2009: 5:09 PM

Emilee J. Pressman, MPH , Office of the Director, Office of Extramural Research, National Institutes of Health, Bethesda, MD
Heidi E. Jones, MPH , Department of Obstetrics & Gynecology, Columbia University, New York, NY
David Bell, MD MPH , Mailman School of Public Health, Columbia University, New York, NY
Jennifer Kerns, MD, MPH , Department of Obstetrics & Gynecology, Columbia University, New York, NY
Stephanie Lykes, MPH , Mailman School of Public Health, Columbia University, New York, NY
Janet Garth , Mailman School of Public Health, Columbia University, New York, NY
Carolyn L. Westhoff, MD , Department of Obstetrics & Gynecology, Heilbrunn Department of Population and Family Health, Columbia University, New York, NY
Background: Chlamydia trachomatis (CT) is the most prevalent bacterial sexually transmitted infection (STI) in the United States. Focus on treatment of males has been neglected. We investigated treatment outcomes of CT infected young men seeking care at an inner city men's clinic in New York City.

Methods: We conducted a retrospective review of all patient charts testing positive for CT from 2004-2005 to document demographic and sexual history, proportion treated, time to treatment, time to test-of-reinfection, and partner treatment and follow-up.

Results: 284 out of 324 (88%) records were reviewed. The median age was 22 years with 57% reporting multiple partners in the last 3 months and 37% reporting symptoms. Only 2 men were not treated, resulting in 99% treated; 82% were treated within 14 days of positive test. 69% had a follow-up visit at the clinic with a median 84 days after treatment. Of those whose next recorded visit was greater than 3 months from index visit, only 60% received a test-of-reinfection. 42% either reported no recent partner or came in secondary to partner treatment. Of the rest, 65% did not receive partner management, 23% received either patient-delivered partner therapy or directly observed partner therapy, and 12% received partner referral.

Conclusions: A high treatment rate of STIs is attainable for young men in low income communities. Follow-up and partner treatment, however, remain problematic. Low-cost strategies such as expedited partner therapy, and self-sampling for test-of-cure may improve patient health outcomes in this population.

Learning Objectives:
1. Evaluate implementation of sexual and reproductive health services targeting young men from low income communities. 2. Describe successes and failures of an existing young menís clinic in managing sexually transmitted infections. 3. Discuss implications of study findings on service planning and delivery for young men in community clinic settings.

Keywords: STD, Male Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted data collection, entry, cleaning, analysis, and write-up.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.