STD Screening of HIV-Infected MSM in HIV Clinics

Hoover, Karen W.; Butler, Mary; Workowski, Kimberly A.; Carpio, Félix; Follansbee, Stephen; Gratzer, Beau; Hare, Brad; Johnston, Barbara; Theodore, John L.; Wohlfeiler, Michael; Tao, Guoyu; Brooks, John T.; Chorba, Terence; Irwin, Kathleen L.; Kent, Charlotte K.

doi:10.1097/olq.0b013e3181e50058

Cited by 94 publications

(88 citation statements)

References 26 publications

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“…Compared to other studies of GC and CT screening among MSM [9,10,13], we found that repeat rectal testing or follow-up testing with any anatomic site specimen was suboptimal among men in our study. The high positivity of repeat rectal tests in our study confirmed the importance of repeat rectal testing for both GC and CT and follow-up testing for pharyngeal GC.…”

Section: Discussioncontrasting

confidence: 99%

“…Although the CDC recommends rectal GC and CT screening of all MSM who report receptive anal sex [2], and previous studies have showed that rectal GC and CT were associated with increased risk for HIV seroconversion among MSM [3,4], rectal GC and CT testing rates have been suboptimal. Reported rectal testing rates varied from 2.3% among HIV-infected MSM who attended HIV clinics to 60% among MSM who attended local public STD clinics [5,7,9,10]. However, most studies of rectal testing among MSM have been done at public STD or HIV clinics or community clinics that were able to perform non-US Food and Drug Administration (FDA)-cleared rectal testing for GC and CT [5-7, 9, 10].…”

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confidence: 99%

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Rectal Infection WithNeisseria gonorrhoeaeandChlamydia trachomatisin Men in the United States

et al. 2016

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Background. Centers for Disease Control and Prevention guidelines recommend at least annual rectal screening of men who have receptive anal intercourse for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT). Only limited national data are available on the prevalence of rectal GC and CT infection among US men.Methods. In collaboration with a large US commercial laboratory, we estimated positivity of the first rectal GC and CT test ("index" test) in men aged 15-60 years tested between January 2013 and May 2015. We estimated the frequency and positivity of pharyngeal or urine specimens tested for GC and CT on the index date, and the frequency and positivity of repeat rectal testing or any follow-up testing at any anatomic site after the index date.Results. Of 52 063 tested men aged 15-60 years, approximately 6.1% were positive for GC only, 8.3% for CT only, and 2.7% for both GC and CT on their index date. On that date, 86.5% had either urine or pharyngeal specimens collected, and 56.1% had both specimens collected. Pharyngeal GC infection was highly associated with rectal GC infection. Follow-up testing after 12 months ranged from 42.4% among uninfected men to 56.7% among infected men on the index date. Positivity was at least 5.7% in rectal GC, rectal CT, or pharyngeal GC at their last test.Conclusions. This analysis of a large number of male rectal specimens tested for GC and CT suggest that routine testing and timely repeat rectal GC and CT testing should be prioritized among men who report receptive rectal sex.

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Section: Discussioncontrasting

confidence: 99%

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Rectal Infection WithNeisseria gonorrhoeaeandChlamydia trachomatisin Men in the United States

et al. 2016

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“…137,158,[165][166][167][168][169] Although HCV has emerged as a STI that is largely confined to HIV-positive MSM, and gonorrhoea and chlamydia are frequently identified, 166 syphilis appears to be the most commonly reported STI coinfection among those with HIV. 159,170 Nonetheless, STI testing rates for nongenital gonorrhoea, chlamydia 171,172 and syphilis 173 in MSM with HIV infection remain below recommended levels.…”

Section: Sti Testing Among Hiv-positive Msmmentioning

confidence: 99%

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

et al. 2014

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Abstract.Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009-May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.

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“…In Melbourne, Australia, only 18% of HIVpositive MSM attending a hospital infectious disease clinic were screened for chlamydia and gonorrhoea (Neisseria gonorrhoeae) during a twice-yearly screening period; 7 in eight large HIV clinics in six cities in the United States, the annual screening rate for rectal chlamydia and gonorrhoea among HIV-positive MSM was less than 10%. 9 The Adult Infectious Disease Service at Auckland City Hospital cares for a large number of people living with HIV infection in the Greater Auckland and Northland regions of New Zealand (an adult population of 1.35 million). All new clinic patients are screened for hepatitis A, B and C virus coinfection; those susceptible to hepatitis A or B are immunised.…”

Section: Introductionmentioning

confidence: 99%

Uptake, yield and resource requirements of screening for asymptomatic sexually transmissible infections among HIV-positive people attending a hospital outpatient clinic

et al. 2014

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Abstract. Background:We performed a prospective audit of screening for asymptomatic sexually transmissible infections (STIs), during an intensive effort to screen all patients at our hospital-based HIV clinic. We aimed to measure the effectiveness and resource implications of our screening program. Methods: All outpatients who attended during an 8-month period were invited to take part in opt-out screening for chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and syphilis. Participants completed a brief questionnaire, were asked about current symptoms of STIs and self-collected specimens for laboratory testing. Results: The majority (535 out of 673, 80%) of the patients who were asked to participate provided specimens for screening. No chlamydia, gonorrhoea or syphilis infections were identified in women (n = 91) or in heterosexual men (n = 76). In contrast, 34 out of 368 (10%) of men who have sex with men tested positive (chlamydia, 25; gonorrhoea, 2; chlamydia and gonorrhoea, 2; syphilis, 5). The laboratory cost of diagnosing each case of rectal chlamydia or gonorrhoea (NZ$664) was substantially lower than the cost of diagnosing each case of urethral infection (NZ$5309). Conclusions: There was high uptake of screening among our clinic population, who preferred screening to be performed at the hospital clinic. The yield of screening men who have sex with men warrants continued annual screening for rectal gonorrhoea and chlamydia and for syphilis.

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STD Screening of HIV-Infected MSM in HIV Clinics

Cited by 94 publications

References 26 publications

Rectal Infection WithNeisseria gonorrhoeaeandChlamydia trachomatisin Men in the United States

Rectal Infection WithNeisseria gonorrhoeaeandChlamydia trachomatisin Men in the United States

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

Uptake, yield and resource requirements of screening for asymptomatic sexually transmissible infections among HIV-positive people attending a hospital outpatient clinic

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