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Eileen F. Dunne M.D., M.P.H.

Repeat Chlamydia trachomatis: Rate and Predictors among Males. Eileen F. Dunne M.D., M.P.H. JB Chapin, C Rietmeijer , CK Kent, J Ellen, C Gaydos, N Willard, L Lloyd, N Birkjukow, S Chung, JA Schillinger, LE Markowitz

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Eileen F. Dunne M.D., M.P.H.

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  1. Repeat Chlamydia trachomatis: Rate and Predictors among Males Eileen F. Dunne M.D., M.P.H. JB Chapin, C Rietmeijer , CK Kent, J Ellen, C Gaydos, N Willard, L Lloyd, N Birkjukow, S Chung, JA Schillinger, LE Markowitz Division of STD Prevention Centers for Disease Control and Prevention

  2. Acknowledgments Baltimore: Jon Ellen Charlotte Gaydos Nancy Willard Michelle Chung Denver: Kees Rietmeijer Laura Lloyd San Francisco: Charlotte Kent Nat Birkjukow CDC: Julie Schillinger Lauri Markowitz Maya Sternberg Johanna Chapin

  3. Background • Chlamydia trachomatis (Ct) infection in females is common and associated with serious sequelae • PID, ectopic pregnancy and infertility • Ct infection in males • Limited resources to screen • Additional information needed to guide program activities

  4. Background • Male Chlamydia Screening Project: • Demonstration project: men ages 15-44 screened for Ct infection • Baltimore • Denver • San Francisco • Seattle • Longitudinal Study: men with Ct infection recruited for a study of repeat infection • Baltimore • Denver • San Francisco

  5. Venue Type BaltimoreDenverSan Francisco (N=10) (N=33) (N=11) Adolescent Primary Care X X X Adult Primary Care X X Juvenile Detention X X Adult Detention X X X School Clinics X X X School Health Fairs X College Clinics X Community Based Organizations X Drug Treatment X STD Clinics X X Street Outreach X X

  6. Objectives To evaluate: • Ct prevalence and predictors of infection • Cost-effectiveness of screening for Ct infection • Partner and network characteristics • Rate and predictors of repeat Ct infection

  7. Objectives • Ct prevalence and predictors of infection • Cost-effectiveness of screening for Ct infection • Partner and network characteristics • Rate and predictors of repeat Ct infection

  8. Longitudinal Study Methods • Men with Ct infection recruited from various venues in Baltimore, Denver, San Francisco • Study Design • Baseline Visit • Questionnaire • Partner management • Follow-up at 1 and 4 months • Screening for Ct using urine NAATs • Questionnaire • Partner management

  9. Longitudinal Study Methods • Analysis: • Men with at least one follow-up visit • Repeat infection: defined as Ct infection at the first or second follow-up visit

  10. Longitudinal Study Methods • Bivariate • Characteristics of men at baseline visit • Characteristics of partners • Baseline partners • New partners • Cox Proportional Hazards Model

  11. Longitudinal Study Enrollment 358 men enrolled 272 (76%) study population 98 (36%) 1 follow-up visit 174 (64%) 2 follow-up visits

  12. Time in Study MedianRange Time to First Follow-up 33 days 21-215 days Time in Study 102 days 21-391 days

  13. 272 study population 403 partners named 74 (18%) partners locatable 65 (16%) partners treated Partner Management Locatable Treated

  14. Study Population

  15. Repeat Infection • Overall: 31 (11%) men had repeat Ct infection • 3 men ≥ 1 repeat infection

  16. Repeat Infection by City

  17. Repeat Infection by City/Venue

  18. Repeat Infection by Age

  19. Repeat Infection by Partner

  20. Repeat Infection by Partner Type

  21. Repeat InfectionSignificant findings

  22. Cox Proportional Hazards Model

  23. Incidence of Repeat Infection • Cumulative Incidence: 42.3 per 100 person years • Most infections occurred early

  24. Cumulative Incidence Curve

  25. Conclusions • Repeat Ct infection among men from diverse geographic locations was 11% • Partner characteristics were not significantly associated with repeat infection • History of STD, and less than high school education were associated with repeat Ct infection

  26. Future Directions • Genotyping • Evaluating partner characteristics and sexual behaviors during study

  27. Contact • Eileen F. Dunne (edunne@cdc.gov) • 404-639-6184

  28. Acknowledgments Baltimore: Jon Ellen Charlotte Gaydos Nancy Willard Michelle Chung Denver: Kees Rietmeijer Laura Lloyd Stewart Thomas San Francisco: Charlotte Kent Nat Birkjukow Seatle Jeanne Marrazzo CDC: Julie Schillinger Lauri Markowitz Maya Sternberg Johanna Chapin John Papp Angelica Wendt

  29. Survival Curve

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