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Cited by 541Reproductive tract infections researchHIV/AIDS Research and InterventionsCervical Cancer and HPV Research

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.

Kent, C. K., Chaw, J. K., Wong, W., Liska, S., Gibson, S., Hubbard, G., Klausner, J. D.·2005·Clinical Infectious Diseases
DOI 10.1086/430704
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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.

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Crossref · 10.1086/430704

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  • Approximately 70% of gonococcal and chlamydial infections might be missed if urogenital-only testing is performed among MSM because most pharyngeal and rectal infections are asymptomatic.

    “Approximately 70% of gonococcal and chlamydial infections might be missed if urogenital-only testing is performed among MSM (212–216) because most pharyngeal and rectal infections are asymptomatic.”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [213]

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Authors
Kent, C. K., Chaw, J. K., Wong, W., Liska, S., Gibson, S., Hubbard, G., & Klausner, J. D.
Affiliations
San Francisco Department of Public Health (US)
Corresponding author
Kent, C. K.
ORCID
Klausner, J. D.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2005-07-01
Volume
41
Issue
1
Pages
67-74
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/430704
OpenAlex
W2133688951
Cited by
541
References
34
Citations by year
2026: 4 · 2025: 14 · 2024: 13 · 2023: 27 · 2022: 22 · 2021: 36 · 2020: 40 · 2019: 31 · 2018: 33 · 2017: 28 · 2016: 38 · 2015: 42 · 2014: 26 · 2013: 38 · 2012: 29
FWCI
12.12
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
Centers for Disease Control and Prevention
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
Keywords
chlamydia, gonorrhea, men who have sex with men, rectal infection, urethral infection, pharyngeal infection, asymptomatic infection, sexually transmitted infections, screening, nucleic acid amplification tests, HIV transmission, San Francisco
MeSH terms
Adult, Chlamydia, Chlamydia Infections, Gonorrhea, Humans, Male, Middle Aged, Neisseria gonorrhoeae, Pharyngeal Diseases, Pharynx, Rectal Diseases, Rectum, San Francisco, Urethra, Urethritis, Sexually Transmitted Diseases, Bacterial, Prevalence, Homosexuality, Male

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