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 four 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 MSM 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.
Conclusion
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.