Table 3 Continued Reference Objective Population Study Design Disease Reinfection Limitations Incidence or Results Prevalence Orr et al. [16] Compare of Ages 14-21; Prospective N/A 60% men Testing variability; subsequent and STD clinic and 3 cohort. STI 73% women high attrition rates reinfection of urban adolescent screening. especially among chlamydia and community men gonorrhea in clinics; Positive adolescnts for gc/ct Burstein et al. Determine Adolescents Retrospective Incidence = 16.4% Only 1.5% males [17] screening Enrolled in cohort. Medical 14.6% in system tested; practices and KMPAS health review. no race, SES, resulting positive plan; At least 1 behavior, sexual test results positive ct test activity available; variability in testing among sites; screening outside KMPAS system Whittington et Identify factors Females 14-34; Prospective N/A 7.9% High attrition; al [18] associated with Reproductive cohort. short follow-up persistent and Interviews and period; variability recurrent medicine ct screening of follow-up chlamydial clinics in 5 intervals; infection in young cities; Positive ct variability in women result testing; recall bias; confounding from couseling; insufficient power; not generalizable Kissinger et al. Determine if age Women 14-30 Prospective N/A 13.8% Insufficient power; [19] of partner years old; cohort. Ct not generalizable; influences Initial ct positive screening high attrition; chlamydia at public family interim behavior recall bias reinfection planning/STD history. clinic in 5 cities Rietmeijer et al. Study incidence Client of an STD Retrospective Incidence = 22.8% Not generalizable; [20] and repeat clinic; Screened cohort. Medical 26.1% influence of infection among for ct more than database asymptomatic clients of STD once 30 days review. chlamydia; history clinic apart of STI not included; high attrition; screening from outside provider
Table 3 Continued Reference Objective Population Study Design Disease Incidence or Prevalence Reinfection Results Limitations Orr et al. [16] Compare of subsequent and reinfection of chlamydia and gonorrhea in adolescnts Ages 14-21; STD clinic and 3 urban adolescent community clinics; Positive for gc/ct Prospective cohort. STI screening. N/A 60% men 73% women Testing variability; high attrition rates especially among men Burstein et al. [17] Determine screening practices and resulting positive test results Adolescents Enrolled in KMPAS health plan; At least 1 positive ct test Retrospective cohort. Medical review. Incidence = 14.6% 16.4% Only 1.5% males in system tested; no race, SES, behavior, sexual activity available; variability in testing among sites; screening outside KMPAS system Whittington et al [18] Identify factors associated with persistent and recurrent chlamydial infection in young women Females 14-34; Reproductive medicine clinics in 5 cities; Positive ct result Prospective cohort. Interviews and ct screening N/A 7.9% High attrition; short follow-up period; variability of follow-up intervals; variability in testing; recall bias; confounding from couseling; insufficient power; not generalizable Kissinger et al. [19] Determine if age of partner influences chlamydia reinfection Women 14-30 years old; Initial ct positive at public family planning/STD clinic in 5 cities Prospective cohort. Ct screening interim behavior history. N/A 13.8% Insufficient power; not generalizable; high attrition; recall bias Rietmeijer et al. [20] Study incidence and repeat infection among clients of STD clinic Client of an STD clinic; Screened for ct more than once 30 days apart Retrospective cohort. Medical database review. Incidence = 26.1% 22.8% Not generalizable; influence of asymptomatic chlamydia; history of STI not included; high attrition; screening from outside provider
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