Hsu KK, et al. - Researchers examined the frequency with which individuals were diagnosed and reported with multiple bacterial sexually transmitted infections (STIs) over time, in Massachusetts. A large proportion of bacterial STIs was reported from a small subpopulation in Massachusetts. Many of the cases had been repeatedly infected and were likely to have a higher impact on STI/HIV rates. In reaching high-volume repeaters, whose STI history could be hidden from clinicians due to fragmented care, public health could play a crucial role.

Methods

• A retrospective, population-based study was conducted of confirmed syphilis, gonorrhea, and chlamydial infections reported to the Massachusetts state surveillance system within a 2-year period, July 28, 2014 - July 27, 2016.

Results

• In this study, 49,142 (1.0%) were reported with ≥1 STI among the Massachusetts population 13-65 years old (4,847,510); 6,999 (14.2% of those with one STI) had ≥2 STIs, accounting for 27.7% of STIs.
• One hundred and eighteen (74%) were men and 42 (26%) women, among cases with ≥5 STIs (high-volume repeaters).
• It was determined that men spanned the age spectrum, were predominantly white, non-Hispanic, and 87% of them reported same-sex contacts.
• Findigs revealed that women were younger, predominantly non-white, without known same-sex contacts.
• Women were re-infected with gonorrhea and chlamydia, or chlamydia alone; none had syphilis or HIV infection.
• Gonorrhea and/or chlamydia was also present in all men with syphilis; 35% were diagnosed with HIV, before, during the study period, or within 10 months after.
• They identified the majority (56%) of high-volume repeaters at more than 1 care site/system.