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RESEARCH ARTICLE (Open Access)
Contents Vol 21(2)

Chlamydia retesting remains low among young women in Australia: an observational study using sentinel surveillance data, 2018–2022

Stephanie C. Munari https://orcid.org/0000-0002-2296-7787 A B * , Anna L. Wilkinson A B C , Jason Asselin A , Louise Owen D , Phillip Read E , Robert Finlayson F , Sarah Martin https://orcid.org/0000-0002-9325-1647 G H , Charlotte Bell I J , Catherine C. O’Connor K , Allison Carter https://orcid.org/0000-0003-2151-2622 K L M , Rebecca Guy K , Anna McNulty https://orcid.org/0000-0003-3174-1242 N , Rick Varma https://orcid.org/0000-0002-0402-0506 N , Eric P. F. Chow https://orcid.org/0000-0003-1766-0657 B O P , Christopher K. Fairley https://orcid.org/0000-0001-9081-1664 O P , Basil Donovan K , Mark Stoove A , Jane L. Goller https://orcid.org/0000-0001-5580-360X B , Jane Hocking https://orcid.org/0000-0001-9329-8501 B , Margaret E. Hellard A B Q and on behalf of the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Blood–Borne Viruses and Sexually Transmissible Infections (ACCESS)
+ Author Affiliations
- Author Affiliations

A Disease Elimination Program, Burnet Institute, Melbourne, Vic., Australia.

B Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.

C School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia.

D Statewide Sexual Health Service, Tas and UTAS School of Medicine, Hobart, Tas., Australia.

E South Eastern Sydney Local Health District, Sydney, NSW, Australia.

F Taylor Square Private Clinic, Sydney, NSW, Australia.

G Canberra Sexual Health Centre, Canberra, ACT, Australia.

H Australian National University, School of Medicine and Psychology, Canberra, ACT, Australia.

I Communicable Disease Control Branch, Department of Health South Australia, Adelaide, SA, Australia.

J Adelaide Sexual Health Centre and Royal Adelaide Hospital, Adelaide, SA, Australia.

K The Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.

L Australian Human Rights Institute, UNSW Sydney, Sydney, NSW, Australia.

M Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.

N Sydney Sexual Health Centre, Sydney, NSW, Australia.

O Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia.

P Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.

Q Department of Infectious Diseases, Alfred Hospital, Melbourne, Vic., Australia.

* Correspondence to: stephanie.munari@burnet.edu.au

Handling Editor: Ian Simms

Sexual Health 21, SH23178 https://doi.org/10.1071/SH23178
Submitted: 10 November 2023  Accepted: 2 February 2024  Published: 19 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC)

Abstract

Background

Chlamydia remains the most notified bacterial sexually transmissible infection in Australia with guidelines recommending testing for re-infection at 3 months post treatment. This paper aimed to determine chlamydia retesting and repeat positivity rates within 2–4 months among young women in Australia, and to evaluate what factors increase or decrease the likelihood of retesting.

Methods

Chlamydia retesting rates among 16–29-year-old women were analysed from Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of sexually transmissible infection and bloodborne virus (ACCESS) sentinel surveillance data (n = 62 sites). Among women with at least one positive test between 1 January 2018 and 31 August 2022, retesting counts and proportions within 2–4 months were calculated. Logistic regression was performed to assess factors associated with retesting within 2–4 months.

Results

Among 8758 women who were positive before 31 August 2022 to allow time for follow up, 1423 (16.2%) were retested within 2–4 months, of whom 179 (12.6%) tested positive. The odds of retesting within 2–4 months were 25% lower if tested in a coronavirus disease 2019 (COVID-9) pandemic year (2020–2022) (aOR = 0.75; 95% CI 0.59–0.95). Among 9140 women with a positive test before 30 November 2022, 397 (4.3%) were retested too early (within 7 days to 1 month) and 81 (20.4%) of those were positive.

Conclusions

Chlamydia retesting rates remain low with around a sixth of women retested within 2–4 months in line with guidelines. Re-infection is common with around one in eight retesting positive. An increase in retesting is required to reduce the risk of reproductive complications and onward transmission.

Keywords: chlamydia, primary care, re-infection, retesting, sexual health, sexually transmissible infection, surveillance, women.

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