Treatment Rates for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in a Metropolitan Area: Observational Cohort Analysis

Abstract

ABSTRACT Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the two most common sexually transmitted infections in the United States (US). The Centers for Disease Control and Prevention (CDC) regularly publishes and updates Sexually Transmitted Infection (STI) Treatment Guidelines. The purpose of this study is to measure and compare treatment rates for CT and GC among public and private providers. Methods Data from multiple sources, including electronic health records (EHRs) and Medicaid claims, were linked and integrated. Cases observed during 2016-2020 were defined based on positive laboratory results. We calculated descriptive statistics and odd ratios based on characteristics of providers and patients, stratifying by public versus private providers. Univariate logistic regression models were used to examine the factors associated with recommended treatment. Results Overall, we found that 82.2% and 63.0% of initial CT and GC episodes, respectively, received CDC-recommended treatment. The public STI clinic treated over 90% of CT and GC cases consistently across the 5-year time period. Private providers were significantly less likely to treat first episodes for CT (79.6%) and GC (53.3%), p < 0.01. Other factors associated with higher likelihood of recommended treatment included being male, being HIV positive, and identifying as Black or multi-racial. Among GC cases, 10.8% received non-recommended treatment; all CT cases with treatment occurred per guidelines. Conclusions Although these treatment rates are higher than previous studies, there remain significant gaps in STI treatment that require intervention from public health.