A study of high-risk, gay men found that urine screening alone misses a significant number of sexually transmitted infections, according to an abstract presented at the annual meeting of the Pediatric Academic Societies (Washington, D.C.; May 4-7). Nongenital chlamydia and gonorrhea (CT/GC) infections may contribute to the burden of infections in this high-risk population and might be missed by a genital (urine screen). A strategy employing triple screening (urine, throat, and rectum samples) may greatly enhance detection of infected individuals. The U.S. Centers for Disease Control and Prevention recommends routine laboratory screening for common sexually transmitted diseases for all sexually active men who have sex with men, with test selection based on types of reported intercourse. However, detailed, accurate sexual histories of youth are not always taken, especially in primary care settings. The researchers analyzed clinical information and GC/CT nucleic acid amplification tests on urine, pharyngeal, and rectal specimens from a young, urban population of 118 men who have sex with men (aged 14 years to 24 years) presenting for care at a community-based, high-risk youth center between March 1 and Oct. 30, 2012. Thirty-six screened patients were positive at one or more sites for gonorrhea, chlamydia, or both. CT […]
A study of high-risk, gay men found that urine screening alone misses a significant number of sexually transmitted infections, according to an abstract presented at the annual meeting of the Pediatric Academic Societies (Washington, D.C.; May 4-7). Nongenital chlamydia and gonorrhea (CT/GC) infections may contribute to the burden of infections in this high-risk population and might be missed by a genital (urine screen). A strategy employing triple screening (urine, throat, and rectum samples) may greatly enhance detection of infected individuals.
The U.S. Centers for Disease Control and Prevention recommends routine laboratory screening for common sexually transmitted diseases for all sexually active men who have sex with men, with test selection based on types of reported intercourse. However, detailed, accurate sexual histories of youth are not always taken, especially in primary care settings.
The researchers analyzed clinical information and GC/CT nucleic acid amplification tests on urine, pharyngeal, and rectal specimens from a young, urban population of 118 men who have sex with men (aged 14 years to 24 years) presenting for care at a community-based, high-risk youth center between March 1 and Oct. 30, 2012. Thirty-six screened patients were positive at one or more sites for gonorrhea, chlamydia, or both. CT was detected in urine, rectal, and pharyngeal samples in two, 11, and two cases respectively, whereas GC was detected in urine, rectal, and pharyngeal samples in nine, 18, and 18 cases respectively. Relying exclusively on urine testing alone would have missed 86 percent of CT infections and 70 percent of GC infections. Rectal testing alone missed 21 percent of CT infections and 38 percent of GC infections, while pharyngeal testing alone missed 78 percent of CT infection and 38 percent of GC infections.
“Notably, rectal screening appeared to have the highest yield, significantly more than urine screening,” write the authors, led by Faiza Ali, M.D., a pediatric infectious disease fellow at Washington University in St. Louis. “Further studies are needed to determine disease prevalence and best screening strategies in other high risks youth groups such as HIV+ adolescents.”
