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RESEARCH ARTICLE
Contents Vol 21(6)

Comparison of IgG serum antibodies, electronic health records and self-report in estimating past infection with Chlamydia trachomatis in a cohort of men who have sex with men

Mary Bridget Waters https://orcid.org/0000-0001-5624-5443 A * , Lindley A. Barbee https://orcid.org/0000-0002-7189-5492 B C , Kevin Hybiske B , Katherine Newman B , Ren Ikeda B , Angela LeClair B , Matthew R. Golden A B C , Olusegun O. Soge B D E , Lisa E. Manhart A and Christine M. Khosropour A
+ Author Affiliations
- Author Affiliations

A Department of Epidemiology, University of Washington, Seattle, WA, USA.

B Department of Medicine, University of Washington, Seattle, WA, USA.

C Public Health – Seattle and King County, HIV/STD Program, Seattle, WA, USA.

D Department of Global Health, University of Washington, Seattle, WA, USA.

E Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.

* Correspondence to: mbwaters@uw.edu

Handling Editor: Michael Marks

Sexual Health 21, SH24101 https://doi.org/10.1071/SH24101
Submitted: 10 May 2024  Accepted: 14 November 2024  Published: 2 December 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

The best method for measuring a history of Chlamydia trachomatis (CT) infections is unknown. We examined the reliability of three methods as markers of past CT infections: IgG serum antibodies, the electronic health record (EHR) and self-report.

Methods

This cross-sectional study used data from a cohort study of 122 MSM in King County, Washington, United States. Sera were tested for IgG using the mixed CT peptide enzyme-linked immunosorbent assay (ELISA). Participant data for past CT diagnoses were extracted from the EHR. Self-report of past CT was collected via survey. We calculated positive and negative percent agreements of CT history using total IgG serum antibodies to CT, past EHR diagnosis and self-report of past CT as reference measures when they were compared with one another.

Results

Of those who were IgG seropositive, only 41.5% had a past diagnosis of CT in their EHRs, but 74.4% self-reported a history of CT. The majority (92.7%) of participants who had a diagnosis of CT in their EHRs reported a past CT infection.

Conclusions

Self-report in combination with IgG serum antibodies to CT may be a more reliable indicator of past CT than EHRs in settings without comprehensive EHRs.

Keywords: antibodies, chlamydia trachomatis, EHR, epidemiology, men who have sex with men, past infection, self-report, sexually transmitted infections.

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