Finding the gaps in retesting for Chlamydia and Gonorrhea: Differences across high-volume testing departments in an urban healthcare setting.

BACKGROUND CDC guidelines recommend that all patients be retested 3 months after a positive chlamydia (CT) or gonorrhea (GC) result. However, retest rates are generally low and only a quarter of patients return to clinic for retesting. This analysis explored retesting patterns in a high STI/HIV-risk setting in order to illuminate gaps in adherence to guideline recommendations. METHODS Retrospective chart data from a large urban safety-net institution were analyzed descriptively. Patients who received a positive CT/GC test from Jan-Feb 2017 were followed for at least 4 months to assess if retesting occurred within approximately 3 months. RESULTS Our sample of 207 patients was primarily non-Hispanic Black (92.8%), <25 years old (63.3%) and female (60.4%). Over half had been initially diagnosed with CT, one-third with GC, and one-tenth with both CT and GC. 89 patients (43.0%) were retested during the observed period; mean time between tests was 2.7 months. Retesting was most common in Infectious Diseases/HIV Primary Care (73.6%) and Obstetrics/Gynecology (44.9%). Patients who were first diagnosed in Emergency Medicine were significantly less likely to be retested. Retested patients included a large number of HIV-positive males (31 of 89 total) and pregnant females (23 of 54 females). CONCLUSIONS 43% of patients were retested within approximately 3 months of their initial positive CT/GC diagnosis, exceeding previously published rates. Nonetheless, in light of the growing STI epidemic, healthcare systems should prioritize retesting across high-volume testing specialties, rethink retesting models, and facilitate referrals to ensure that patients receive guideline-recommended, comprehensive STI care.