Factors Related to Chlamydia trachomatis and Neisseria gonorrhoeae Reinfection Among STD Clinic Patients

Background:

To calculate the rate of reinfection by chlamydia and/or gonorrhea at a sexually transmitted disease clinic, in an area with high incidence of STDs, and to compare demographic characteristics and sexual practices among reinfected vs nonreinfected patients.

Methods:

The charts of all 208 individuals (over age 15 and mostly African-American and Afro-Caribbean) who were diagnosed by PCR with chlamydia and/or gonorrhea during December 2005 to June 2006 at an STD clinic were reviewed. Since the population studied is a young and mobile group, follow-up was enhanced with records from the New York City Department of Health. The rate of reinfection by either pathogen was calculated within one year of diagnosis/treatment of initial diagnosis and data regarding age, sex, number of sexual partners, MSM, and condom use was collected.

Results:

The calculated rate of reinfection is higher than estimated at 19% (N=39). C. trachomatis was identified more commonly than N. gonorrhoeae for initial and secondary diagnoses. Reinfection mostly affected the young (42% of reinfected men ages 20-24 and 46% of women ages 15-19). Men ages 15-19 years were 2.77 times more likely to develop reinfection than men over twenty. Women ages 15-19 were 6.67 times more likely to develop reinfection than women over twenty. Sexual behavior was inadequately documented.

Conclusions:

The calculated rate of reinfection, enhanced by the inclusion of NYCDOH database, was higher than expected. Also, reinfection mostly affected younger patients. This study demonstrates the need for more outreach targeting young people and improved documentation/counseling efforts by the clinic.