Rate and Predictors of Repeat Chlamydia trachomatis Infection Among Men

Abstract

Background: Chlamydia trachomatis (Ct) infection, especially repeat infection, is associated with serious sequelae among women, including pelvic inflammatory disease, ectopic pregnancy, and infertility. There are few reports evaluating repeat infection and predictors among men treated for Ct infection. Objective: To measure the predictors and incidence of repeat Ct infection among men. Methods: Men 15 to 35 years of age were screened for Ct infection in different venues in Baltimore, Denver, and San Francisco using urine-based nucleic acid amplification tests. Men with Ct infection were evaluated for repeat Ct infection from February 2001 until September 2003. Enrolled men had a baseline, 1-month, and 4-month follow-up visit and were tested for Ct infection at each visit. Project staff sought to locate and notify all female sex partners of infected men during the study to provide testing and treatment. We evaluated predictors of repeat Ct infection, time to infection, and incidence of infection. Results: Three hundred fifty-nine men were recruited into the study and 272 (76%) had at least 1 follow-up visit with Ct results. Repeat infection occurred in 13% of men with Ct infection; there was no significant difference in repeat infection by site (Denver 13%, Baltimore 13%, San Francisco 12%). Independent predictors of repeat infection were history of an STD and venue. Incidence of repeat infection was 45.4 infections per 100 person years. Conclusion: Repeat Ct infection is common among men and similar in geographically distinct cities. Incidence of repeat Ct infection support routine rescreening of men within the first 3 months after Ct infection.