title: Is the recall of men who have sex with men (MSM) diagnosed as having bacterial sexually transmitted infections (STIs) for re-screening a feasible and effective strategy?
abstract: OBJECTIVE
  To assess the feasibility and outcomes of recalling men who have sex with men (MSM) diagnosed as having a bacterial sexually transmitted infection (STI) for re-screening.
  
  
  METHODS
  This evaluation was conducted from December 2008 for a 9-month period. MSM diagnosed as having a bacterial STI in that period were offered recall for re-screening 3 months after their diagnosis. Re-screening rates and infection incidence were calculated. Differences in baseline characteristics by re-screening status and factors predictive of infection at re-screening were assessed using the Mann-Whitney test, χ(2) test and logistic regression.
  
  
  RESULTS
  Of the 337 MSM diagnosed as having a bacterial STI, 301 were offered recall. Of these, 206 (68.4%) re-screened after 3 months, 30 (10%) declined and the remainder did not re-attend despite giving verbal consent. Compared with those not re-screening, those re-screening were less likely to be HIV positive (p=0.001), but there was no difference in baseline risk behaviours. There were 15 diagnoses of bacterial STIs at re-screening (29 per 100 person-year follow-up (pyfu); 95% CI 14.3 to 43.7) and five new HIV diagnoses of whom three had a negative test at baseline, one tested negative 6 months earlier and one never tested. Among those testing at both time points, the HIV incidence was 8.3 per 100 pyfu (95% CI 0.0 to 17.7).
  
  
  CONCLUSIONS
  This evaluation demonstrates a 'recall for re-screening' strategy is feasible in terms of high re-screening rates and incidence of new infections diagnosed. Experimental evidence is needed to assess cost-effectiveness and whether it achieves its aim of reducing transmission of STIs and HIV.
authors.affiliation: Department of Genitourinary Medicine, Mortimer Market Centre, Camden Provider Services, Central North and West London Foundation Trust, London, UK. d.harte@nhs.net
authors.forename: Derval
authors.initials: D
authors.lastname: Harte
authors.forename: Danielle
authors.initials: D
authors.lastname: Mercey
authors.forename: Jay
authors.initials: J
authors.lastname: Jarman
authors.forename: Paul
authors.initials: P
authors.lastname: Benn
mesh_terms: D000328:Adult; D000368:Aged; D003140:Communicable Disease Control / Q000379:methods*; D005500:Follow-Up Studies; D006678:HIV; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy* / Q000635:transmission