Prevalence of Rectal Chlamydial and Gonococcal Infections: A Systematic Review

Abstract

We undertook a systematic review to examine rectal Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (Ng) infections in women and men who have sex with men (MSM). English-language publications measuring rectal Ct or Ng prevalence using nucleic acid amplification tests were eligible. Searching multiple electronic databases, we identified 115 eligible reports published between January 2000 and November 2016. Overall, the prevalence of rectal Ct (9%) was higher than that of rectal Ng (4.7%). Rectal Ct prevalence was similar in MSM (9%) and women (9.2%), whereas rectal Ng prevalence was higher in MSM (6.1%) than in women (1.7%). Generally, rectal Ct prevalence was similar in sexually transmitted disease clinics (9.1%) and nonsexual health clinics (8.6%), whereas rectal Ng prevalence was somewhat lower in sexually transmitted disease clinics (4.5%) than in nonsexual health clinics (6%). These infections seem to be relatively common across a range of populations and clinical settings, highlighting the need for additional research on these preventable, treatable conditions.

Factors associated with anorectalChlamydia trachomatisorNeisseria gonorrhoeaetest positivity in women: a systematic review and meta-analysis

“…Firstly, as our aim was to investigate both CT and NG anorectal in the same population, our systematic search focused on identifying papers that reported both CT and NG anorectal estimates so any papers reporting only one infection were excluded; it is possible that findings in these papers were different from those in our review. However, systematic reviews of anorectal CT in women show similar results to ours providing validity to our results [6][7][8]. Secondly, not every individual woman was tested for both anorectal CT and NG in each study, potentially introducing some selection bias into the comparison between the two organisms.…”

“…In recent years, there has been considerable discussion about the prevalence and role of anorectal CT in women with three reviews reporting high median anorectal CT test positivity estimates ranging from 6.0% to 9.2% [6][7][8]. Further, there have been calls for anorectal CT screening in women [9].…”

STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany

“…HIV-participants were significantly younger than HIV+ MSM (median 35 IQR [30][31][32][33][34][35][36][37][38][39][40][41][42][43] vs. 44 [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52], p < 0.01) and less likely to be born in Germany (67.2% vs. 80.8%, p < 0.01), but they were more likely to have acquired university-entrance diploma (74.6% vs. 54.4%, p < 0.01). The median number of male sex partners was significantly higher in HIV-MSM than in HIV+ (6 [3][4][5][6][7][8][9][10][11][12][13][14][15] vs. 4 [1][2][3][4]…”

“…The differences between HIV+ and HIV-participants are described above. HIV−/PrEP+ reported the highest number of male sex partners (median 11 IQR [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]) and the highest proportion of sex without using condoms (91.8%), including insertive and receptive CAI (78.4, 73.8%) and COI (94.0, 88.7%). Also they reported to more frequently use party drugs (64.4%).…”

“…This may lead to severe sequelae, and serve as ongoing transmission reservoir. Extragenital STI in MSM are frequent [8][9][10][11][12] and can contribute substantially to the further spread if not diagnosed and treated. In previous studies, HIVpositive (HIV+) MSM often showed higher prevalences of STI than HIV-negative (HIV-) MSM [13,14].…”