title: Repeat infection with Neisseria gonorrhoeae among active duty U.S. Army personnel: a population-based case-series study.
abstract: Little information is known on the rate of repeat gonorrhea infection among U.S. military personnel. We analyzed all gonorrhea cases reported to the Defense Medical Surveillance System during 2006-2012 to determine the rate of repeat infection. During the seven-year study period, 17,602 active duty U.S. Army personnel with a first incident gonorrhea infection were reported. Among the 4987 women with a first gonorrhea infection, 14.4% had at least one repeat infection. Among the 12,615 men with a first gonorrhea infection, 13.7% had at least one repeat infection. Overall, the rate of repeat gonorrhea infection was 44.5 and 48.9 per 1000 person-years for women and men, respectively. Service members aged 17-19 years (hazard ratio [HR] for women = 1.51; HR for men = 1.71), African-American personnel (HR for women = 1.26; HR for men = 2.17), junior enlisted personnel (HR for women = 2.64; HR for men = 1.37), and those with one year or less of service (HR for women = 1.23; HR for men = 1.37) were at higher risk of repeat infection. The findings from this study highlight the need to develop targeted prevention initiatives including education, counseling, and retesting to prevent gonorrhea reinfections among U.S. Army personnel.
authors.affiliation: 1 Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
authors.forename: Christian T
authors.initials: CT
authors.lastname: Bautista
authors.affiliation: 2 Infectious Disease Research Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Eyako K
authors.initials: EK
authors.lastname: Wurapa
authors.affiliation: 2 Infectious Disease Research Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Warren B
authors.initials: WB
authors.lastname: Sateren
authors.affiliation: 1 Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Morris
authors.affiliation: 1 Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
authors.forename: Bruce P
authors.initials: BP
authors.lastname: Hollingsworth
authors.affiliation: 3 Armed Forces Health Surveillance Branch, Public Health Division, Defense Health Agency, Silver Spring, MD, USA.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Sanchez
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009344:Neisseria gonorrhoeae; D011159:Population Surveillance; D012008:Recurrence; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Gonorrhea; epidemiology; military; repeat; sexually transmitted infection; surveillance