Patterns of Extragenital Chlamydia and Gonorrhea in Women and Men Who Have Sex with Men Reporting a History of Receptive Anal Intercourse
BACKGROUND:
Screening
for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in men who have
sex with men is risk based. Despite high frequencies of oral and receptive anal
intercourse (RAI) among women, extragenital screening is not recommended.
METHODS:
Women (n
= 175) and men who have sex with men (n = 224) primarily recruited from a
sexually transmitted infection clinic reporting a lifetime history of RAI
completed a structured questionnaire and clinician-collected swab samples from
the rectum, pharynx, vagina (women), and urine (men). CT and GC were detected
using 2 commercial nucleic acid amplification tests (Aptima Combo 2; Hologic,
Inc, Bedford, MA; Xpert CT/NG, Cepheid Innovation, Sunnyvale, CA).
RESULTS:
The
median age of the population was 26 years, 62% were white, and 88% were
enrolled from a sexually transmitted disease clinic. Men were more likely than
women to have GC (22.8% vs. 3.4%) and CT (21.9% vs. 12.6%). In men versus
women, GC was detected in 16.5% versus 2.3% of pharyngeal swabs, 11.6% versus
2.3% of rectal swabs, and 5.4% versus 2.9% of urine samples or vaginal swabs.
C. trachomatis was detected in 2.2% versus 1.7% of pharyngeal swabs, 17.4%
versus 11.4% of rectal swabs, and 4.5% versus 10.3% for urogenital sites in men
versus women. Overall 79.6% of CT and 76.5% of GC in men and 18.2% of CT and
16.7% of GC in women were detected only in the pharynx or rectum.
CONCLUSION:
Reliance
on urogenital screening alone misses most of GC and CT in men and more than 15%
of infections in women reporting RAI.
- 1From the *University of Pittsburgh, Pittsburgh, PA; and †Magee-Womens Research Institute (http://www.mwrif.org/12), Pittsburgh, PA.
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