Article Text
Abstract
Introduction Guidelines advocate re-testing Chlamydia trachomatis(CT) and Neisseria gonorrhoeae(NG) positives within 3–12 months. Sexual risk behaviour is associated with CT/NG. Having a high intention to re-test could be a predictor for behaviour such as sexual risk behaviour. In this study we assess whether intention for re-testing before patients have received their test result is associated with CT or NG test result.
Methods Between 2014–2015, all STI clinic attendees answered the 5 point scale question “are you planning to return for testing the next year?” before CT/NG testing. Intention was categorised into very low(1), low(2), neutral(3) high(4) and very high(5). Patients were categorised in; women, heterosexual men and men who had sex with men in the past 6 months (MSM). The association between intention and CT/NG was assessed using backward logistic regression with determinants; age, warned by (ex)partner, symptoms and number of sex partners<6 months. Neutral intention was the reference category.
Results Intention to re-test was lower among women and heterosexual men (median 3, inter quartile range (IQR) 2–4) compared to MSM (5, IQR 4–5) (both p<0.001). Overall CT prevalence was 12.9%(n=359) in women, 13.7%(n=216) in heterosexual men and 10.5%(n=116) in MSM. For NG this was 1.5%(n=43), 1.8%(n=28) and 12.1% (n=134) respectively. In heterosexual men, having a high intention to re-test was associated with genital CT (OR1.5, 95% CI 1.03–1.3). In women, having a very high intention was associated with genital NG (OR3.5, 95% CI 1.3–9.0) and in MSM with anorectal NG (OR4.0, 95% CI 1.4–11.7). Of CT positives, 48.9%(n=338) had (very) high intention, for NG positives this was 81.5%(n=167).
Conclusion High intention to re-test was associated with genital CT/NG in heterosexuals and with anorectal NG in MSM. Healthcare providers could ask for and increase patients’ intention to re-test during the consultation by motivational interviewing, even without the CT/NG test result. Additionally re-testing should be promoted in diagnosed CT/NG positives, in accordance with guidelines.