Retesting young STI clinic visitors with urogenital Chlamydia trachomatis infection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls

Sex Transm Infect. 2016 Mar;92(2):124-9. doi: 10.1136/sextrans-2015-052115. Epub 2015 Sep 24.

Abstract

Objectives: The objective of this study is to assess the effect of reminder text messages 6 months after the initial treatment on retest and chlamydia reinfection rates in young heterosexuals compared with a historical control group and to assess factors associated with both outcomes.

Methods: Heterosexual people (aged 16-23 years), testing positive for urogenital chlamydia, were offered a retest after 6 months. Participants received a text message reminder at 6 months after the initial chlamydia diagnosis. Rates of retest uptake and the result of the retest were analysed using Cox regression. Prevalence ratios (PRs) were calculated to identify factors associated with these outcomes. Furthermore, the retest rate was compared with the retest rate of a historical control group.

Results: 30.6% (253/838) of the study group returned within 5-8 months compared with 9.2% (140/1530) in the historical control group. Women and persons who were not notified for a sexually transmitted infection (STI) at inclusion were more likely to return for a retest. 20.4% (56/275) of participants had a chlamydia reinfection upon retesting. Reinfection was higher in participants reporting STI-related symptoms (PR 3.2, 95% CI 1.8 to 5.6) and in participants who were notified for an STI at retest (PR 5.3, 95% CI 2.4 to 11.5).

Conclusions: A text message reminder appeared to have a clear, positive impact on the resulting retest rate. These results also indicate that retesting is necessary to identify chlamydia reinfections.

Keywords: ADOLESCENT; CHLAMYDIA TRACHOMATIS; COMMUNITY SERVICES; EPIDEMIOLOGY (GENERAL); PUBLIC HEALTH.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Ambulatory Care Facilities
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / prevention & control*
  • Chlamydia trachomatis / isolation & purification*
  • Female
  • Follow-Up Studies
  • Heterosexuality / statistics & numerical data
  • Humans
  • Male
  • Mass Screening*
  • Netherlands / epidemiology
  • Patient Compliance
  • Prevalence
  • Program Evaluation
  • Prospective Studies
  • Recurrence
  • Reminder Systems*
  • Text Messaging*
  • Young Adult