This article is more than 5 years old. Information may no longer be current.
Extragenital chlamydia, gonorrhea common in MSM, but often missed
Click Here to Manage Email Alerts
Extragenital gonorrhea and chlamydia infections were common among men who have sex with men visiting STD clinics, but many were not tested for them, CDC researchers have found.
“A substantial burden of [gonorrhea] and [chlamydia] infection among MSM would not have been identified, and presumptively would not have been treated, if screening and treatment were based on urethral screening alone,” the researchers wrote in Clinical Infectious Diseases. “To control the ongoing spread of [these] infections and potentially reduce the risk of MSM, efforts are needed to expand the availability and use of rectal and pharyngeal [nucleic acid amplification tests] for this population and to facilitate implementation of appropriate screening practices.”
The researchers collected data on 21,994 MSM who visited 42 STD clinics throughout the country from July 2011 to June 2012. They evaluated the number of MSM who were tested for extragenital gonorrhea and/or chlamydia. They then determined the number of infections that would have gone undetected with urogenital screening alone.
The majority (83.9%) were tested for urogenital gonorrhea either at their most recent visit or in the previous 12 months, but only 65.9% were tested for pharyngeal infection and 50.4% were tested for rectal infection. Among those who were tested, 11.1% were positive for a urogenital infection, 7.9% were positive for a pharyngeal infection and 10.2% were positive for a rectal infection. Extragenital infections represented 53% of all gonorrhea infections.
For chlamydia, 81.4% also were tested for urogenital infection at their most recent visit or in the previous 12 months. Only 31.7% were tested for pharyngeal infection and 45.9% were tested for rectal infection. Among those who were tested, 8.4% were positive for urogenital infection, 2.9% were positive for pharyngeal infection and 14.1% were positive for rectal infection. Fifty-two percent of chlamydia infections were extragenital.
Among those with positive rectal gonorrhea test who also had a urethral test at the same visit, 71.8% were negative. In addition, urethral tests were negative for 73.8% of pharyngeal gonorrhea infections, 92.2% of pharyngeal chlamydia infections and 88.3% of rectal chlamydia infections.
“While many MSM in this population were screened for extragenital [infections] at least annually according to CDC recommendations, a number of MSM were not screened for extragenital [infections] at all,” the researchers wrote. “The fact that extragenital infections are typically asymptomatic highlights the importance of screening based on a comprehensive history including sites of exposure.”
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts