Positivity and Follow-up Testing of Chlamydia trachomatis and Neisseria gonorrhoeae Infections in Universally Screened Female Basic Military Trainees.

Introduction: Follow-up testing is recommended three months after patients initially test positive with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Follow-up testing adherence in the United States has been reported below one third of women, even in universally insured populations. We assessed both the positivity of CT and GC infections in female basic military trainees and the rates of follow-up testing for those who tested positive.

Methods: Between January 1, 2006-December 31, 2021, female Air Force Basic Military Trainees were universally screened with urinary nucleic acid amplification testing for CT and GC. Those who tested positive were evaluated to determine demographic information as well as follow-up testing rates. Patients who were evaluated with a repeat CT/GC NAAT test within 12 months after a positive CT/GC test result were considered to have received appropriate follow-up.

Results: 5,022 (5.2%) of 97,168 trainees tested positive for only-CT (4,749 (4.8%)), only GC (138 (0.1%)) or both CT/GC (135 (0.1%) during the study period. Those at increased risk of infection were those <24 years of age, Hispanic and Black individuals, high school education level, and single women. Of the 4,687 still in the military at three months after diagnosis, 3,268 (69.7%) had repeat testing within 12 months. There was no significant difference in follow-up testing by age, race, educational level, marital status, or organism causing original infection.

Conclusion: Follow-up testing among female USAF basic military trainees is higher than in other universally insured populations. This study demonstrates remaining barriers to adherence to recommended guidelines.