Gonorrhoea and chlamydia testing rates of HIV-infected men: low despite guidelines.
OBJECTIVE
Screening HIV-infected men for gonorrhoea (GC) and chlamydia (CT) may decrease HIV transmission and reduce the incidence of pelvic inflammatory disease in female partners. This study determined GC/CT testing rates in a clinical HIV cohort before and after 2003 when the US Centers for Disease Control and Prevention issued guidelines for GC/CT screening.


METHODS
First GC/CT testing episodes were identified for all men enrolling in a Baltimore HIV clinic from 1999 to 2007. Multivariate Cox and logistic regression were used to assess clinical and demographic factors associated with being tested and with having a positive result.


RESULTS
Among 1110 men, the rate of GC/CT testing upon clinic enrollment increased from 4.0% prior to 2003 to 16.5% afterwards, and the rate of ever being tested increased from 34.2% to 49.1% (p<0.001 for both comparisons). Among men with same sex contact, 10% of first testing episodes included extragenital sites. Among the 342 men ever-tested, 5.2% had positive results on first testing. Predictors of testing included enrolling after 2003, younger age, frequent visits and black race. Predictors of a positive test result included CD4 count ≥ 200 cells/mm(3) and younger age.


CONCLUSIONS
GC/CT testing rates among men increased substantially after the 2003 guidelines but remain low. Disseminating existing evidence for GC/CT screening and promoting operational interventions to facilitate it are warranted.
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21287-2100, USA. sberry8@jhmi.edu
Stephen A
SA
Berry
Khalil G
KG
Ghanem
Kathleen R
KR
Page
Chloe L
CL
Thio
Richard D
RD
Moore
Kelly A
KA
Gebo
D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D015142:Baltimore; D002690:Chlamydia Infections / Q000150:complications / Q000175:diagnosis*; D042241:Early Diagnosis; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis*; D015658:HIV Infections / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012747:Sexual Partners