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. 2014 Jun;58(11):1564-70.
doi: 10.1093/cid/ciu184. Epub 2014 Mar 18.

Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men--STD Surveillance Network, United States, 2010-2012

Monica E Patton  1 , Sarah Kidd, Eloisa Llata, Mark Stenger, Jim Braxton, Lenore Asbel, Kyle Bernstein, Beau Gratzer, Megan Jespersen, Roxanne Kerani, Christie Mettenbrink, Mukhtar Mohamed, Preeti Pathela, Christina Schumacher, Ali Stirland, Jeff Stover, Irina Tabidze, Robert D Kirkcaldy, Hillard Weinstock
Affiliations

Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men--STD Surveillance Network, United States, 2010-2012

Monica E Patton et al. Clin Infect Dis. 2014 Jun.

Abstract

Background: Gonorrhea (GC) and chlamydia (CT) are the most commonly reported notifiable diseases in the United States. The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) be screened for urogenital GC/CT, rectal GC/CT, and pharyngeal GC. We describe extragenital GC/CT testing and infections among MSM attending sexually transmitted disease (STD) clinics.

Methods: The STD Surveillance Network collects patient data from 42 STD clinics. We assessed the proportion of MSM attending these clinics during July 2011-June 2012 who were tested and positive for extragenital GC/CT at their most recent visit or in the preceding 12 months and the number of extragenital infections that would have remained undetected with urethral screening alone.

Results: Of 21 994 MSM, 83.9% were tested for urogenital GC, 65.9% for pharyngeal GC, 50.4% for rectal GC, 81.4% for urogenital CT, 31.7% for pharyngeal CT, and 45.9% for rectal CT. Of MSM tested, 11.1% tested positive for urogenital GC, 7.9% for pharyngeal GC, 10.2% for rectal GC, 8.4% for urogenital CT, 2.9% for pharyngeal CT, and 14.1% for rectal CT. More than 70% of extragenital GC infections and 85% of extragenital CT infections were associated with negative urethral tests at the same visit and would not have been detected with urethral screening alone.

Conclusions: Extragenital GC/CT was common among MSM attending STD clinics, but many MSM were not tested. Most extragenital infections would not have been identified, and likely would have remained untreated, with urethral screening alone. Efforts are needed to facilitate implementation of extragenital GC/CT screening recommendations for MSM.

Keywords: STD; extragenital chlamydia; extragenital gonorrhea; men who have sex with men (MSM).

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

Figures

Figure 1
Figure 1
Proportion of men who have sex with men who tested positive for gonorrhea and chlamydia by anatomic site and test type. Abbreviations: CT, chlamydia; GC, gonorrhea.
Figure 2
Figure 2
Proportion of extragenital gonorrhea and chlamydia infections associated with concurrent negative urethral tests.
See this image and copyright information in PMC

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