Impact of the COVID-19 Pandemic on Chlamydia, Gonorrhea, and Pelvic Inflammatory Disease Encounters in a United States Uniformed Service Female Beneficiary Population

We sought to evaluate the impact of the COVID-19 pandemic on trends in chlamydia, gonorrhea, and pelvic inflammatory disease (PID) encounter rates within the Military Health System. This cross-sectional study queried electronic health records of 18- to 44-year-old female active duty service members and dependents during the pre-pandemic period (January 2018-February 2020), pandemic period 1 (March 2020-March 2021), and pandemic period 2 (April 2021-April 2022). We calculated monthly chlamydia, gonorrhea, and PID encounter rates using ICD-10 codes. We used change point analysis for trends in encounter rates and Poisson regression for differences in rates by age, active duty status, military rank, TRICARE region, and pandemic period. There were 36,102, 7,581, and 16,790 unique individuals with chlamydia, gonorrhea, and PID encounters, respectively, over the pre-pandemic and pandemic time frames. Chlamydia and gonorrhea encounter rates were highest in ages 18 to 19, in active duty service members, and junior enlisted compared to senior enlisted and officer sponsor rank. Chlamydia and gonorrhea encounter rates varied by TRICARE region. Chlamydia encounter rates were lower in both pandemic periods 1 and 2 compared to the pre-pandemic period, whereas gonorrhea encounter rates were lower only in pandemic period 2 compared to the pre-pandemic period. Trend analysis showed monthly chlamydia encounter rates did not significantly change from January 2018 through August 2020, and then decreased 2.4% monthly through the remainder of the study period (P