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Cited by 206Reproductive tract infections researchHIV/AIDS Research and InterventionsSyphilis Diagnosis and Treatment

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

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Patton, M. E., Kidd, S., Llata, E., Stenger, M., Braxton, J., Asbel, L., Bernstein, K., Gratzer, B. +11 more·2014·Clinical Infectious Diseases
DOI 10.1093/cid/ciu184
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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.

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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 [212]

    The Discussion reports that urethral-only screening would miss more than 70% of extragenital gonorrhea infections and more than 85% of extragenital chlamydia infections among MSM tested at both sites. It also says extragenital infections are typically asymptomatic. The claim omits the extragenital and paired-testing qualifiers, making approximately 70% sound like the proportion of all gonococcal and chlamydial infections missed. (LLM, conf=0.90)

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  1. Klein EJ, Fisher LS, Chow AW, Guze LB. Anorectal gonococcal infec- tion. Ann Intern Med 1977; 86:340-6.

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Authors
Patton, M. E., Kidd, S., Llata, E., Stenger, M., Braxton, J., Asbel, L., Bernstein, K., Gratzer, B., Jespersen, M., Kerani, R., Mettenbrink, C., Mohamed, M., Pathela, P., Schumacher, C., Stirland, A., Stover, J., Tabidze, I., Kirkcaldy, R. D., & Weinstock, H.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention (US)
  • Philadelphia Department of Public Health (US)
  • San Francisco Department of Public Health (US)
  • Howard Brown Health Center (US)
  • State of Louisiana (US)
  • Public Health – Seattle & King County (US)
  • Denver Public Health (US)
  • Connecticut Department of Public Health (US)
  • New York City Department of Health and Mental Hygiene (US)
  • Johns Hopkins University (US)
  • Los Angeles County Department of Public Health (US)
  • Virginia Department of Health (US)
  • Chicago Department of Public Health (US)
Corresponding author
Patton, M. E.
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2014-03-18
Volume
58
Issue
11
Pages
1564-1570
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/cid/ciu184
OpenAlex
W2127995782
Cited by
206
References
37
Citations by year
2026: 5 · 2025: 5 · 2024: 17 · 2023: 14 · 2022: 16 · 2021: 20 · 2020: 19 · 2019: 29 · 2018: 27 · 2017: 18 · 2016: 15 · 2015: 17 · 2014: 4
FWCI
14.66
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Clinical Infectious Diseases (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (CC999999)
  • Centers for Disease Control and Prevention (RFA PS08-865)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
Keywords
men who have sex with men, STI screening, pharyngeal infection, rectal infection, urogenital infections, STD surveillance, STD clinics
MeSH terms
Adolescent, Adult, Chlamydia Infections, Genitalia, Male, Gonorrhea, Humans, Male, Middle Aged, Pharynx, Rectum, United States, Prevalence, Homosexuality, Male, Young Adult, Epidemiological Monitoring

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