Sentinel Surveillance of Rectal Chlamydia and Gonorrhea Among Males—San Francisco, 2005–2008

Marcus, Julia L.; Bernstein, Kyle T.; Stephens, Sally C.; Snell, Ameera; Kohn, Robert; Liska, Sally; Klausner, Jeffrey D.

doi:10.1097/olq.0b013e3181b76c42

Cited by 18 publications

(22 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, this study did not adjust for sexual risk factors or symptomatic presentations. The authors attributed the stable rates of positivity to a significant increase in STI testing rates [34], supporting our hypothesis that increased testing reduces positivity rates in MSM. In contrast to our findings, an Australian MSM cohort study has reported high incidences of urethral and anal chlamydia and gonorrhea.…”

Section: Discussionsupporting

confidence: 85%

See 1 more Smart Citation

Trends in chlamydia and gonorrhea positivity among heterosexual men and men who have sex with men attending a large urban sexual health service in Australia, 2002-2009

et al. 2011

View full text Add to dashboard Cite

BackgroundTo determine whether chlamydia positivity among heterosexual men (MSW) and chlamydia and gonorrhea positivity among men who have sex with men (MSM), are changing.MethodsComputerized records for men attending a large sexual health clinic between 2002 and 2009 were analyzed. Chlamydia and gonorrhea positivity were calculated and logistic regression used to assess changes over time.Results17769 MSW and 8328 MSM tested for chlamydia and 7133 MSM tested for gonorrhea. In MSW, 7.37% (95% CI: 6.99-7.77) were chlamydia positive; the odds of chlamydia positivity increased by 4% per year (OR = 1.04; 95% CI: 1.01-1.07; p = 0.02) after main risk factors were adjusted for. In MSM, 3.70% (95% CI: 3.30-4.14) were urethral chlamydia positive and 5.36% (95% CI: 4.82-5.96) were anal chlamydia positive; positivity could not be shown to have changed over time. In MSM, 3.05% (95% CI: 2.63-3.53) tested anal gonorrhea positive and 1.83% (95% CI: 1.53-2.18) tested pharyngeal gonorrhea positive. Univariate analysis found the odds of anal gonorrhea positivity had decreased (OR = 0.93; 95% CI: 0.87-1.00; p = 0.05), but adjusting for main risk factors resulted in no change. Urethral gonorrhea cases in MSM as a percentage of all MSM tested for gonorrhea also fell (p < 0.001).ConclusionsThese data suggest that chlamydia prevalence in MSW is rising and chlamydia and gonorrhea prevalence among MSM is stable or declining. High STI testing rates among MSM in Australia may explain differences in STI trends between MSM and MSW.

show abstract

Section: Discussionsupporting

confidence: 85%

“…Marcus et al reported positivity rates at several clinics in San Francisco from 2005 to 2008, and found no change in either anal chlamydia or gonorrhea positivity [34]. However, this study did not adjust for sexual risk factors or symptomatic presentations.…”

Section: Discussionmentioning

confidence: 85%

Trends in chlamydia and gonorrhea positivity among heterosexual men and men who have sex with men attending a large urban sexual health service in Australia, 2002-2009

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Extragenital infections may also be increasing in prevalence [ 59 , 77 , 95 ], as several studies have reported higher prevalence of extragenital infections among MSM in recent time periods. However, this could also reflect more thorough screening practices or improved testing methods [ 97 , 98 ]. Extragenital infections among MSM are associated with concurrent partners, existing HIV infection ( n = 2 studies), condomless anal sex ( n = 3), and drug use during sex ( n = 1) [ 62 , 65 , 69 , 89 , 91 ].…”

Section: Resultsmentioning

confidence: 99%

Extragenital Infections Caused byChlamydia trachomatisandNeisseria gonorrhoeae: A Review of the Literature

Chan

Robinette

Montgomery

et al. 2016

Infectious Diseases in Obstetrics and Gynecology

281

245

View full text Add to dashboard Cite

In the United States, sexually transmitted diseases due to Chlamydia trachomatis and Neisseria gonorrhoeae continue to be a major public health burden. Screening of extragenital sites including the oropharynx and rectum is an emerging practice based on recent studies highlighting the prevalence of infection at these sites. We reviewed studies reporting the prevalence of extragenital infections in women, men who have sex with men (MSM), and men who have sex only with women (MSW), including distribution by anatomical site. Among women, prevalence was found to be 0.6–35.8% for rectal gonorrhea (median reported prevalence 1.9%), 0–29.6% for pharyngeal gonorrhea (median 2.1%), 2.0–77.3% for rectal chlamydia (median 8.7%), and 0.2–3.2% for pharyngeal chlamydia (median 1.7%). Among MSM, prevalence was found to be 0.2–24.0% for rectal gonorrhea (median 5.9%), 0.5–16.5% for pharyngeal gonorrhea (median 4.6%), 2.1–23.0% for rectal chlamydia (median 8.9%), and 0–3.6% for pharyngeal chlamydia (median 1.7%). Among MSW, the prevalence was found to be 0–5.7% for rectal gonorrhea (median 3.4%), 0.4–15.5% for pharyngeal gonorrhea (median 2.2%), 0–11.8% for rectal chlamydia (median 7.7%), and 0–22.0% for pharyngeal chlamydia (median 1.6%). Extragenital infections are often asymptomatic and found in the absence of reported risk behaviors, such as receptive anal and oral intercourse. We discuss current clinical recommendations and future directions for research.

show abstract

“…In San Francisco, routine screening for gonorrhea and chlamydia at the urogenital, pharyngeal, and rectal sites is widely available for MSM and has been shown to lead to significantly higher rates of gonorrhea and chlamydia diagnoses, primarily through diagnosis of asymptomatic infections [15,16]. After increased rates of syphilis were reported in 2001 and 2002, there have been multiple public health campaigns for routine STI screening of MSM which may partially explain the increased percentage of cases diagnosed in primary care offices during our study period.…”

Section: Discussionmentioning

confidence: 99%

Racial/ethnic and sexual behavior disparities in rates of sexually transmitted infections, San Francisco, 1999-2008

et al. 2010

View full text Add to dashboard Cite

BackgroundRacial/ethnic minorities and men who have sex with men (MSM) represent populations with disparate sexually transmitted infection (STI) rates. While race-specific STI rates have been widely reported, STI rates among MSM is often challenging given the absence of MSM population estimates. We evaluated the race-specific rates of chlamydia and gonorrhea among MSM and non-MSM in San Francisco between 1999-2008.Methods2000 US Census data for San Francisco was used to estimate the number of African-American, Asian/Pacific Islander, Hispanic, and white males. Data from National HIV Behavioral Surveillance (NHBS) MSM 1, conducted in 2004, was used to estimate the total number of MSM in San Francisco and the size of race/ethnic sub-populations of MSM. Non-MSM estimates were calculated by subtracting the number of estimated MSM from the total number of males residing in San Francisco. Rates of MSM and non-MSM gonorrhea and chlamydia reported between 1999 and 2008 were stratified by race/ethnicity. Ratios of MSM and non-MSM rates of morbidity were calculated by race/ethnicity.ResultsBetween 1999-2008, MSM accounted for 72% of gonorrhea cases and 51% of chlamydia cases. Throughout the study period, African-American MSM had the highest chlamydia rate with 606 cases per 100,000 in 1999 increasing to 2067 cases per 100,000 in 2008. Asian/Pacific Islander MSM consistently had the lowest rate among MSM with1003 cases per 100,000 in 2008. The ratio of MSM/non-MSM for chlamydia was highest among whites 11.6 (95% CI: 8.8-14.4) and Asian/Pacific Islanders 8.6 (95% CI: 6.2-11), and lowest among African-Americans 1.53 (95% CI: 1.2-1.9) and Hispanics 4.43 (95% CI: 2.8-6.0). Gonorrhea rates were similar for African-American, white, and Hispanic MSM between 2137-2441 cases per 100,000 in 2008. Asian/Pacific Islander MSM had the lowest gonorrhea rate with 865 cases per 100,000 in 2008. The ratio of MSM/non-MSM for gonorrhea was highest among whites 11.6 (95% CI: 8.8-14.4) and Asian/Pacific Islanders 8.6 (95% CI: 6.2-11), and lowest among African-Americans 1.53 (95% CI: 1.2-1.9) and Hispanics 4.43 (95% CI: 2.8-6.0).ConclusionsFor all racial/ethnic groups in San Francisco, MSM carried a substantially higher burden of STIs compared to non-MSM except among African-American men. These racial and sexual behavior disparities warrant further public health attention and resources.

show abstract

Sentinel Surveillance of Rectal Chlamydia and Gonorrhea Among Males—San Francisco, 2005–2008

Cited by 18 publications

References 8 publications

Trends in chlamydia and gonorrhea positivity among heterosexual men and men who have sex with men attending a large urban sexual health service in Australia, 2002-2009

Trends in chlamydia and gonorrhea positivity among heterosexual men and men who have sex with men attending a large urban sexual health service in Australia, 2002-2009

Extragenital Infections Caused byChlamydia trachomatisandNeisseria gonorrhoeae: A Review of the Literature

Racial/ethnic and sexual behavior disparities in rates of sexually transmitted infections, San Francisco, 1999-2008

Contact Info

Product

Resources

About