Evaluation of chlamydia and gonorrhea screening criteria: San Francisco sexually transmitted disease clinic: 1997 to 1998.
OBJECTIVE
The advent of more sensitive diagnostic testing technologies and competition in public healthcare spending have resulted in a reevaluation of sexually transmitted disease (STD) screening practices in an attempt to target populations at greatest risk. Screening among populations with a < 2% prevalence of chlamydia and a < 1% prevalence of gonorrhea may not be cost-effective.


OBJECTIVE
To identify subpopulations with a low prevalence of chlamydia or gonorrhea.


METHODS
The prevalence of genital chlamydia and gonorrhea among asymptomatic STD patients screened from 1997 to 1998 at San Francisco City Clinic was stratified by demographic and behavioral risk factors.


RESULTS
The prevalence of chlamydia and gonorrhea was 3.4% and 1.1% among asymptomatic women and 4.0% and 1.0% among asymptomatic men, respectively. Two low-prevalence subpopulations identified among asymptomatic patients were women older than 29 years (chlamydia, 1.2%) and men who have sex with women (gonorrhea, 0.8%).


CONCLUSIONS
These data identified low-prevalence subpopulations among asymptomatic STD patients. As a result, the STD screening criteria at San Francisco City Clinic were changed accordingly.
Ciemins
E L
EL
San Francisco Department of Public Health, Sexually Transmitted Disease Prevention and Control Services, California, USA.
Kent
C K
CK
Flood
J
J
Klausner
J D
JD
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology*; D002985:Clinical Protocols / Q000592:standards; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods* / Q000592:standards* / Q000639:trends; D020380:Needs Assessment; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards* / Q000639:trends; D015995:Prevalence; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D012725:Sexual Behavior / Q000706:statistics & numerical data