Chlamydia trachomatis among Youth - Testing Behaviour and Incidence of Repeat Testing in Stockholm County, Sweden 2010-2012

Abstract

BackgroundWidespread testing and screening for genital Chlamydia trachomatis is often advocated as an important method to halt the epidemic. Sweden has long tradition of opportunistic screening services. Nevertheless infections rates have continued to rise over the past two decades, despite increased access to testing and treatment services.MethodsIn this retrospective cohort study we describe the testing behavior for genital Chlamydia trachomatis among youth in Stockholm County, with a focus on repeated testing. Specifically we (a) study positivity rates among single and repeat testers, we (b) estimate the incidence of repeat testing and the rates of infection in repeat testing episodes, and we (c) estimate time to repeat testing and factors associated with repeat testing. All youth (aged ≥12 and <26) that tested for Chlamydia trachomatis in one of 33 Youth Health Clinics in Stockholm County between 1 January 2010 and 31 December 2012 were included in the study.ResultsThe cohort comprised a total of 65,951 individuals who did 119,699 tests during the study period. 42% of youth were repeat testers, the incidence of repeat testing was 35.0/100 person years. The overall baseline prevalence was 7.9%. Positivity rates of baseline tests among repeat testers were nearly twice as high among single testers of either sex. These were 17.1% and 9.8% among male repeat and single testers respectively. The corresponding rates for women were 9.4% and 4.3%. Positivity rates among repeat tests did not decline compared to the overall baseline positivity. Baseline test result and sex significantly influenced the occurrence of repeat testing.ConclusionAmong repeat testers we found high rates of Chlamydia trachomatis both at baseline and at repeat tests which suggests the possibility that this group might be continuing to engage in unsafe sexual practices. Given the extent of repeat testing and the high positivity rates on repeat testing, further research among this group is required to inquire into reasons for repeated testing.

Retesting and repeat positivity following diagnosis of Chlamydia trachomatis and Neisseria gonorrhoea in New Zealand: a retrospective cohort study

“…Whereas some studies reporting reinfection and retesting rates have focussed only specific patient populations (often limited to females) [ 4 , 19 , 20 ], a strength of our study was the robust sample comprising laboratory data for all males and females diagnosed with chlamydia or gonorrhoea in the region over a two-and-a-half-year period. Test locations included over 100 primary health care (general practice, youth health, student health and family planning) and sexual health clinics and all individuals had a minimum of 6 months follow-up.…”

Repeat testing for chlamydia trachomatis, a “safe approach” to unsafe sex? a qualitative exploration among youth in Stockholm

“…Nevertheless, repeated testing for C.trachomatis is relatively common behaviour among youth living in Stockholm County. In a recent study, we found that 42% of youth using the testing services at the Youth Health Clinics (YHC) in Stockholm re-tested for C.trachomatis during a 3 year period [ 11 ]. The repeat testers in our study tested between two to 19 times over the study period [ 11 ].…”

“…In a recent study, we found that 42% of youth using the testing services at the Youth Health Clinics (YHC) in Stockholm re-tested for C.trachomatis during a 3 year period [ 11 ]. The repeat testers in our study tested between two to 19 times over the study period [ 11 ]. Re-testing was associated with being female, a previous positive test and living in a high- or middle-income area of Stockholm.…”

“…Re-testing was associated with being female, a previous positive test and living in a high- or middle-income area of Stockholm. Furthermore, we found high rates of C.trachomatis among repeat testers both at baseline and at repeat tests which suggests the possibility that this group might be continuing to engage in unsafe sexual practices [ 11 ]. However, the reasons for repeat C.trachomatis testing on an individual level are still unknown.…”

Who should be screened for Chlamydia trachomatis infection? Three years' experience at a University Hospital in Switzerland

“…Our experience working in the ambulatory Gynecological consultations at Geneva University Hospital (HUG) suggests that these recommendations may need precisions. International recommendations advise CT screening for women younger than 25 years old and pregnant women [8][9][10]. Screening is also justified in older women with risk factors, such as having a new sex partner or multiple sex partners.…”