Comparison of Methods to Increase Repeat Testing in Persons Treated for Gonorrhea and/or Chlamydia at Public Sexually Transmitted Disease Clinics

Malotte, C Kevin DrPH*; Ledsky, Rebecca MBA†; Hogben, Matthew PhD‡; Larro, Michelle MA*; Middlestadt, Susan PhD†; St. Lawrence, Janet S. PhD‡; Olthoff, Glen MA§; Settlage, Robert H. MD, MPH∥; Van Devanter, Nancy L. DrPH¶; the GCAP Study Group

Article

Background: Retesting 3 to 4 months after treatment for those infected with chlamydia and/or gonorrhea has been recommended.

Goal: We compared various methods of encouraging return for retesting 3 months after treatment for chlamydia or gonorrhea.

Study: In study 1, participants were randomly assigned to: 1) brief recommendation to return, 2) intervention 1 plus $20 incentive paid at return visit, or 3) intervention 1 plus motivational counseling at the first visit and a phone reminder at 3 months. In study 2, participants at 1 clinic were randomly assigned to 4) intervention 1, 5) intervention 1 plus phone reminder, or 6) intervention 1 plus motivational counseling but no telephone reminder.

Results: Using multiple logistic regression, the odds ratios for interventions 2 and 3, respectively, compared with intervention 1 were 1.2 (95% confidence interval [CI], 0.6–2.5) and 2.6 (95% CI, 1.3–5.0). The odds ratios for interventions 5 and 6 compared with intervention 4 were 18.1 (95% CI, 1.7–193.5) and 4.6 (95% CI, 0.4–58.0).

Conclusions: A monetary incentive did not increase return rates compared with a brief recommendation. A reminder phone call seemed to be the most effective method to increase return.

A study comparing various methods of encouraging return for retesting 3 months after treatment for chlamydia or gonorrhea found that a reminder phone call seemed to be the most effective method and a monetary incentive was not effective.

From the * Community Health and Social Epidemiology Programs, Health Science Department, California State University, Long Beach, California; the † Academy for Educational Development, Washington, DC; the ‡ Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; § Prince George’s County Health Department, Prince George’s County, Maryland; ∥ Los Angeles County Department of Health Services, Los Angeles, California; and the ¶ Center for Applied Public Health, Mailman School of Public Health, Columbia University, New York, New York

The GCAP Study Group: Los Angeles, CA: C. Kevin Malotte, DrPH, Michelle Larro, MA, Keisha Paxton, PhD, Lisa V. Smith, DrPH, Robert H. Settlage, MD, MPH, Robyn Davis, MPH, CHES, Gary A. Richwald, MD, MPH, Typhanye V. Penniman, MPH, and James Gaines, BS. Harlem, NY: Nancy VanDevanter, DrPH, Cheryl Merzel, DrPH, Peter Messeri, PhD, Amy Bleakley, MPH, Isaac Weisfuse, MD, MPH, Alwyn Cohall, MD, Susan Blank, MD, Renee Mayer Cohall, CSW, Deborah Levine, ACSW, and Michele Peake, MA, Med. Prince George’s County, MD: Susan E. Middlestadt, PhD, Rebecca Ledsky, MBA, Glen Olthoff, MPA, Jonathan Zenilman, MD, Gillian VanBlerk, MD, MPH, and Chizoba Ukairo, MPH. CDC and NIMH: Matthew Hogben, PhD, Janet St. Lawrence, PhD, Thomas L. Gift, PhD, and Willo Pequegnat, PhD.

This work was supported by the Centers for Disease Control and Prevention, and the National Institute of Mental Health. The authors wish to thank the staff and patients at the participating STD clinics.

Correspondence: C. Kevin Malotte, DrPH, California State University, Long Beach, 5500 Atherton Street, Suite 400, Long Beach, CA 90815. E-mail: kmalotte@csulb.edu.

Received for publication February 5, 2004, and accepted May 26, 2004.

© Copyright 2004 American Sexually Transmitted Diseases Association