1. Pilot Study: Re-screening Adolescent and Young Adult Women for Chlamydia Infection Alison Muse NYSDOH Bureau of STD Control Region II IPP meeting November 1, 2006

2. Background  Federal recommendation to re-screen women with Ct infection in 3 months  Studies show 11% to 15% of women treated for Ct are re-infected 3-4 months after treatment.

3. Objectives  Determine incidence of re-infection and associated risk factors  Assess feasibility of implementing re-screening in IPP clinics Assess effectiveness of reminder methods for encouraging clients to return for re-screening Assess effectiveness of reminder methods for encouraging clients to return for re-screening

4. Methods Design: Prospective, cross sectional study. Setting:Nine IPP STD clinics. Population: 15-24 year old women testing Ct positive Sept 1, 2005 to Feb 28, 2006 & providing written informed consent.

5. Methods Reminder Method: R1: Mail R2: Telephone R3: Unassisted Telephone follow-up for no-shows unless R3 specified Incentive:$15 gift card provided at return visit Risk Assessment: Behavioral risk questionnaire administered at baseline and return visit.

6. Preliminary Results Baseline  1,347 screened, 179 (13.3%) infected  70 (39%) gave informed consent. Re-screening  56 scheduled to return 21 re-screened, 4 (19%) Ct positive 21 re-screened, 4 (19%) Ct positive 12/21 completed risk assessment at follow up 12/21 completed risk assessment at follow up

7. Preliminary Results: Reminder Method Method* Scheduled (N=70) Return (N=21) R145 6 R218 5 R3 2 1 Not Specified 5 0 Telephone F-U N/A 9 * R1: Mail, R2: Telephone, R3: Unassisted

8. Preliminary Conclusions  Implementation difficult at clinic level  Mail reminder most popular, least successful  Combined reminder plus incentive has not enhanced return rates.