title: 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.
abstract: BACKGROUND
  To determine whether chlamydia positivity among heterosexual men (MSW) and chlamydia and gonorrhea positivity among men who have sex with men (MSM), are changing.
  
  
  METHODS
  Computerized 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.
  
  
  RESULTS
  17769 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).
  
  
  CONCLUSIONS
  These 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.
authors.affiliation: Melbourne School of Population Health, The University of Melbourne, Vic, Australia.
authors.forename: Lenka A
authors.initials: LA
authors.lastname: Vodstrcil
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.forename: Glenda
authors.initials: G
authors.lastname: Fehler
authors.forename: David
authors.initials: D
authors.lastname: Leslie
authors.forename: Jennifer
authors.initials: J
authors.lastname: Walker
authors.forename: Catriona S
authors.initials: CS
authors.lastname: Bradshaw
authors.forename: Jane S
authors.initials: JS
authors.lastname: Hocking
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002689:Chlamydia / Q000235:genetics / Q000302:isolation & purification; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000382:microbiology; D003153:Community Health Services / Q000706:statistics & numerical data; D006069:Gonorrhea / Q000453:epidemiology*; D020010:Heterosexuality / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000235:genetics / Q000302:isolation & purification; D012189:Retrospective Studies; D055815:Young Adult