Gonorrhea and chlamydia rates among 12-24 year old patients in an urban health system.

BACKGROUND Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) infection rates continue to rise. Screening guidelines have largely focused on sexually active females and men who have sex with men (MSM) populations. Healthcare-system testing and infection rates, particularly among heterosexual males, are poorly understood. Our aim was to evaluate CT and GC testing and prevalence among 12-24 year-old patients in an urban Federally Qualified Health Center (FQHC) system. METHODS This retrospective study analyzed electronic health record data from 2017-2019 in a large system of FQHCs in Denver, CO. Abstracted data included demographics, sexual activity, sexual orientation, and laboratory results. Chi square tests were used to evaluate differences between groups. RESULTS Of the 44,021 patients included, 37.6% were tested, 15.0% were positive for CT, and 3.4% were positive for GC. Heterosexual males had a testing rate of 22.8%, and positivity rates of CT and GC at 13.1% and 3.0% respectively. Among tested patients documented as not sexually active, 7.5% were positive for CT. Multiple or re-infections were detected in 29% of patients. CONCLUSIONS This study shows low testing rates and high rates of CT and GC infections among all patients, including heterosexual males and those documented as not sexually active. Improved screening of these populations in the primary care setting may be key to combating the sexually transmitted disease epidemic.