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. 2022 Jun 17;9(7):ofac298.
doi: 10.1093/ofid/ofac298. eCollection 2022 Jul.

Anatomic Site-Specific Gonorrhea and Chlamydia Testing and Incidence Among People With HIV Engaged in Care at 4 US Clinical Centers, 2014-2018

Timothy W Menza  1 , Stephen A Berry  2 , Julie Dombrowski  3 , Edward Cachay  4 , Heidi M Crane  3 , Mari M Kitahata  3 , Kenneth H Mayer  5
Affiliations

Anatomic Site-Specific Gonorrhea and Chlamydia Testing and Incidence Among People With HIV Engaged in Care at 4 US Clinical Centers, 2014-2018

Timothy W Menza et al. Open Forum Infect Dis. .

Abstract

Background: The incidence of Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) is increasing in the United States; however, there are limited data on anatomic site-specific GC/CT among people with HIV (PWH).

Methods: We reviewed records of all PWH in care between January 1, 2014, and November 16, 2018, at 4 sites in the CFAR Network of Integrated Clinical Systems Cohort (CNICS; n = 8455). We calculated anatomic site-specific GC/CT testing and incidence rates and used Cox proportional hazards models modified for recurrent events to examine sociodemographic and clinical predictors of GC/CT testing and incidence at urogenital, rectal, and pharyngeal sites. We also calculated site-specific number needed to test (NNT) to detect a positive GC/CT test.

Results: Of 8455 PWH, 2460 (29.1%) had at least yearly GC/CT testing at any anatomic site. The rates of urogenital, rectal, and pharyngeal GC were 1.7 (95% CI, 1.6-1.9), 3.2 (95% CI, 3.0-3.5), and 2.7 (95% CI, 2.5-2.9) infections per 100 person-years, respectively. The rates of urogenital, rectal, and pharyngeal CT were 1.9 (95% CI, 1.7-2.1), 4.3 (95% CI, 4.0-4.5), and 0.9 (95% CI, 0.8-1.0) infections per 100 person-years, respectively. PWH 16-39 years old experienced greater GC/CT rates at all anatomic sites, while men who have sex with men experienced greater rates of extragenital infections. NNTs for urogenital, rectal, and pharyngeal GC/CT were 20 (95% CI, 19-21), 5 (95% CI, 5-5), and 9 (95% CI, 8-9), respectively.

Conclusions: Many PWH are not tested annually for GC/CT, and rates of GC/CT infection, particularly rates of extragenital infections, are high. We identified groups of PWH who may benefit from increased site-specific GC/CT testing.

Keywords: chlamydia; gonorrhea; incidence; people with HIV; testing.

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References

    1. Workowski KA, Bachmann LH, Chan, PA, et al. . Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep 2021; 70:1–187. - PMC - PubMed
    1. Landovitz RJ, Gildner JL, Leibowitz AA. Sexually transmitted infection testing of HIV-positive Medicare and Medicaid enrollees falls short of guidelines. Sex Transm Dis 2018; 45:8–13. - PMC - PubMed
    1. Li J, Armon C, Palella FJ, et al. . Chlamydia and gonorrhea incidence and testing among patients in the human immunodeficiency virus outpatient study (HOPS), 2007–2017. Clin Infect Dis Off Publ Infect Dis Soc Am 2020; 71:1824–35. - PubMed
    1. Centers for Disease Control and Prevention . Sexually Transmitted Disease Surveillance, 2019. Centers for Disease Control and Prevention; 2021.
    1. Secco AA, Akselrod H, Czeresnia J, et al. . Sexually transmitted infections in persons living with HIV infection and estimated HIV transmission risk: trends over time from the DC Cohort. Sex Transm Infect 2020; 96:89–95. - PMC - PubMed