Systems Approaches to Improving Rates of Extragenital Chlamydia and Gonorrhea Screening Among Men Who Have Sex With Men Engaged in Human Immunodeficiency Virus Care

Prevalence of Gonorrhea and Chlamydia Testing by Anatomical Site Among Men Who Have Sex With Men in HIV Medical Care, United States, 2013–2014

“…6,7 Systems approaches, such as electronic health systems that include prompts for STD testing and use of patient self-collected specimens, may help minimize these barriers and facilitate extragenital testing. 13…”

Long-term follow-up after introduction of a systematic sexually transmitted infection screening program for men having sex with men living with HIV in a primary care setting: uptake, STI incidence, and risk factors for infection and reinfection

“…Increasing rates of CT/NG testing in HIV clinics may be achieved by reduction of barriers at the clinician, patient, and system level [ 19 ]. Much of the above-mentioned contrast between syphilis and CT/NG testing coverage may stem from physician’s lack of time and discomfort with sexual history taking and collection of STI swabs [ 20 , 21 ].…”

Modeling the Cost-Effectiveness of Express Multisite Gonorrhea Screening Among Men Who Have Sex With Men in the United States

“…Urogenital gonococcal infection in males is frequently symptomatic, whereas rectal and pharyngeal (i.e., extragenital) infections are mostly asymptomatic, 5,6 and symptom-based testing often misses extragenital infections. Asymptomatic infections may serve as transmission reservoirs, 3,7–10 yet levels of extragenital asymptomatic screening are likely lower than recommended 10–15 . Potential explanations for this include provider time constraints and discomfort with taking sexual risk histories 16 …”

“…Asymptomatic infections may serve as transmission reservoirs, 3,7-10 yet levels of extragenital asymptomatic screening are likely lower than recommended. [10][11][12][13][14][15] Potential explanations for this include provider time constraints and discomfort with taking sexual risk histories. 16 Express sexually transmitted infection (STI) screening clinics could potentially enable more men to receive triple-site screening (i.e., be screened at all 3 anatomical sites) without increasing costs.…”