title: Retesting young STI clinic visitors with urogenital Chlamydia trachomatis infection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls.
abstract: OBJECTIVE
  The objective of this study is to assess the effect of reminder text messages 6 months after the initial treatment on retest and chlamydia reinfection rates in young heterosexuals compared with a historical control group and to assess factors associated with both outcomes.
  
  
  METHODS
  Heterosexual people (aged 16-23 years), testing positive for urogenital chlamydia, were offered a retest after 6 months. Participants received a text message reminder at 6 months after the initial chlamydia diagnosis. Rates of retest uptake and the result of the retest were analysed using Cox regression. Prevalence ratios (PRs) were calculated to identify factors associated with these outcomes. Furthermore, the retest rate was compared with the retest rate of a historical control group.
  
  
  RESULTS
  30.6% (253/838) of the study group returned within 5-8 months compared with 9.2% (140/1530) in the historical control group. Women and persons who were not notified for a sexually transmitted infection (STI) at inclusion were more likely to return for a retest. 20.4% (56/275) of participants had a chlamydia reinfection upon retesting. Reinfection was higher in participants reporting STI-related symptoms (PR 3.2, 95% CI 1.8 to 5.6) and in participants who were notified for an STI at retest (PR 5.3, 95% CI 2.4 to 11.5).
  
  
  CONCLUSIONS
  A text message reminder appeared to have a clear, positive impact on the resulting retest rate. These results also indicate that retesting is necessary to identify chlamydia reinfections.
authors.affiliation: Public Health Service Twente, Enschede, The Netherlands.
authors.forename: Cjg
authors.initials: C
authors.lastname: Kampman
authors.affiliation: Public Health Service Twente, Enschede, The Netherlands.
authors.forename: Fdh
authors.initials: F
authors.lastname: Koedijk
authors.affiliation: Public Health Service West-Brabant, Breda, The Netherlands.
authors.forename: Hcm
authors.initials: H
authors.lastname: Driessen-Hulshof
authors.affiliation: Department of Primary and Community Care, Radboudumc University Medical Center, Nijmegen, The Netherlands.
authors.forename: Jla
authors.initials: J
authors.lastname: Hautvast
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Ivf
authors.initials: I
authors.lastname: van den Broek
mesh_terms: D000293:Adolescent; D000554:Ambulatory Care Facilities; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D005500:Follow-Up Studies; D020010:Heterosexuality / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance; D015995:Prevalence; D015397:Program Evaluation; D011446:Prospective Studies; D012008:Recurrence; D017010:Reminder Systems; D060145:Text Messaging; D055815:Young Adult
keywords: ADOLESCENT; CHLAMYDIA TRACHOMATIS; COMMUNITY SERVICES; EPIDEMIOLOGY (GENERAL); PUBLIC HEALTH