A number of authors have recently questioned whether we should be screening asymptomatic men who have sex with men (MSM) for Neisseria gonorrhoeae (Ng) and Chlamydia trachomatis (Ct).1–3 These authors have noted that screening for these infections results in very high levels of antimicrobial consumption with the attendant risks of antimicrobial resistance (AMR) induction.2 This is concerning if one considers that the decision to screen for these infections was not based on evidence from randomised controlled trials (RCTs).1 Screening guidelines typically require high-quality RCTs to show clear evidence of net benefit of screening before a screening programme can be introduced.4

We recently published the results of the first RCT assessing the efficacy of three-site, three monthly screening (3×3 screening) for Ng/Ct versus non-screening in reducing the incidence of these infections among MSM taking HIV pre-exposure prophylaxis (PrEP).4 We found that 3×3 screening was associated with a slightly decreased incidence of Ct infections, but not Ng infections. This finding …