Prevalence of Rectal, Urethral, and Pharyngeal Chlamydia and Gonorrhea Detected in 2 Clinical Settings among Men Who Have Sex with Men: San Francisco, California, 2003
Top Cited Papers
Open Access
- 1 July 2005
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 41 (1), 67-74
- https://doi.org/10.1086/430704
Abstract
Background. The Centers for Disease Control and Prevention developed screening and diagnostic testing guidelines for chlamydia and gonorrhea at urethral, rectal, and pharyngeal sites for men who have sex with men (MSM). However, in most clinical settings, rectal chlamydial testing is not performed for MSM, and primarily sexually transmitted disease (STD) clinics alone perform routine rectal and pharyngeal gonorrhea screening for asymptomatic men. Methods. We evaluated the prevalence of rectal, urethral, and pharyngeal chlamydial and gonococcal infections among MSM seen at the municipal STD clinic and the gay men's community health center. We also determined the proportion of asymptomatic rectal infections, described the patterns of single and multiple anatomic sites of infection, and evaluated the proportion of chlamydial infections that would be missed and not treated if MSM were not routinely tested for chlamydia. We tested specimens using previously validated nucleic acid amplification tests (NAATs). Results. The prevalence of infection varied by anatomic site (chlamydia: rectal, 7.9%; urethral, 5.2%; and pharyngeal, 1.4%; for gonorrhea, rectal, 6.9%; urethral, 6.0%; and pharyngeal, 9.2%). Approximately 85% of rectal infections were asymptomatic supporting the need for routine screening. Because 53% of chlamydial infections and 64% of gonococcal infections were at nonurethral sites, these infections would be missed and not treated if only urethral screening was performed. In addition, >70% of chlamydial infections would be missed and not treated if MSM were tested only for gonorrhea. Conclusions. Because these infections enhance both HIV transmission and susceptibility, clinical settings serving MSM should evaluate the prevalence of chlamydial and gonococcal infections by anatomic site using validated NAATs.Keywords
This publication has 23 references indexed in Scilit:
- Validation of Roche COBAS Amplicor Assay for Detection of Chlamydia trachomatis in Rectal and Pharyngeal Specimens by an omp1 PCR AssayJournal of Clinical Microbiology, 2004
- Screening for Neisseria gonorrhoeae and Chlamydia trachomatis in Men Who Have Sex With Men at Male-Only SaunasSexually Transmitted Diseases, 2003
- Treating Asymptomatic Sexually Transmitted Diseases at Anonymous HIV Counseling and Testing SitesSexually Transmitted Diseases, 2003
- Increases in Gonorrhea and Sexual Risk Behaviors Among Men Who Have Sex With Men:Sexually Transmitted Diseases, 2003
- Pilot Study of COBAS PCR and Ligase Chain Reaction for Detection of Rectal Infections Due to Chlamydia trachomatisJournal of Clinical Microbiology, 2003
- Sexually Transmitted Diseases and Human Immunodeficiency Virus–Discordant Partnerships among Men Who Have Sex with MenClinical Infectious Diseases, 2002
- Prevalence of chlamydia and gonorrhoea among a population of men who have sex with menSexually Transmitted Infections, 2002
- Guidance for STD Clinical Preventive Services for Persons Infected With HIVSexually Transmitted Diseases, 2001
- Sexually Transmitted Disease and HIV Screening Guidelines for Men Who Have Sex With MenSexually Transmitted Diseases, 2001
- Reexamining the Prevalence of Chlamydia trachomatis Infection Among Gay Men With UrethritisSexually Transmitted Diseases, 2000