Background: Reinfection and partner transmission are common with Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT). We assessed treatment and follow-up laboratory testing for GC and CT and evaluated associations with patient-and system-level factors. Methods:The analysis included positive GC and/or CT nucleic acid amplification test results from patients aged 14 to 24 years at a federally qualified health center system site in Denver, CO, from January 2018 to December 2019. Outcomes assessed include treatment within 14 days, HIV/syphilis testing within 6 months, and repeat GC and CT testing within 2 to 6 months. Bivariate and multivariable regression modeling assessed associated factors.Results: Among 27,168 GC/CT nucleic acid amplification tests performed, 1.8% (484) were positive for GC and 7.8% (2125) were positive for CT. Within the assessed time frames, 87% (2275) of patients were treated, 54.1% (1411) had HIV testing, 50.1% (1306) had syphilis testing, and 39.9% (1040) had GC and CT retesting. Older patients were more likely to receive treatment (adjusted odds ratio 1.13; 95% confidence interval, 1.00-1.27; P = 0.05) than younger patients, whereas males were less likely to receive GC and CT retesting (adjusted odds ratio, 0.19; 95% confidence interval, 0.11-0.33; P < 0.001) than females. Patients treated on the day of testing were less likely to receive follow-up laboratory tests than those treated 2 to 14 days after.Conclusions: Although most patients received antibiotic treatment, only about half received HIV/syphilis testing and less than half received GC and CT retesting. It is critical to find innovative strategies to improve treatment and follow-up management of these infections to decrease complications, reduce transmission, and combat the rising rates of sexually transmitted infections.N eisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) are the 2 most commonly reported sexually transmitted infections (STIs) in the United States, and the prevalence has increased substantially in the past decade. 1 Adolescents and young adults aged 14 to 24 years make up half of the new STI diagnoses each year despite comprising only one-quarter of the sexually active population. 2 In addition, antibiotic-resistant GC infection is listed on the Centers for Disease Control and Prevention's (CDCs) urgent threat list. 3,4 Untreated infections result in considerable morbidity and may lead to infertility in women. 5,6 Thus, prompt treatment is imperative to prevent complications and to reduce disease transmission. 7,8 Patients with GC and/or CT also have an increased risk of human immunodeficiency virus (HIV) transmission, and they may not use condoms consistently; thus, HIV testing is recommended for individuals who have GC and/or CT infections. 7,8 Given escalating rates of syphilis in Denver, CO, routine syphilis testing after a GC and/or CT infection is recommended based on national guidelines recommending testing for syphilis in highrisk individuals (residence in high-prevalence areas or other risk fact...

We describe a case of Cryptococcal choroiditis in a person with advanced HIV/AIDS. A 29-year-old male with AIDS presented with fever, photophobia, and ataxia secondary to cryptococcal and toxoplasma meningoencephalitis. Dilated fundoscopic examination revealed bilateral and multifocal posterior infiltrates consistent with cryptococcal choroiditis. Treatment with parenteral and intravitreal liposomal amphotericin B, oral flucytosine, and oral trimethoprim-sulfamethoxazole led to resolution of his symptoms and improvement in his vision. Our case documents a rare, intraocular opportunistic infection and highlights the importance of ophthalmologic examination in immunocompromised hosts with visual symptoms and invasive fungal infection. We discuss diagnostic and treatment considerations in cryptococcal choroiditis.

Our study assessed adolescents' and emerging adults' (ages 14-24 years) preferences for opt-out gonorrhea and chlamydia screening compared with risk-based screening. Most participants (93%) preferred opt-out gonorrhea and chlamydia testing compared with risk-based testing (6%), and opt-out testing was associated with less sexually transmitted infection-related stigma ( P < 0.05).

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