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Gonorrhoea and chlamydia testing rates of HIV-infected men: low despite guidelines
  1. Stephen A Berry,
  2. Khalil G Ghanem,
  3. Kathleen R Page,
  4. Chloe L Thio,
  5. Richard D Moore,
  6. Kelly A Gebo
  1. Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Stephen A Berry, Division of Infectious Diseases, 1830 E. Monument St / Room 457, Baltimore, MD 21287-2100, USA; sberry8{at}


Objectives 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/mm3 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.

  • Health service research
  • gonorrhea
  • Chlamydia
  • screening
  • HIV secondary prevention

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  • Funding National Center for Research Resources 1KL2RR025006-01 and National Institutes of Health 5T32AI007291-19, 3R01AG026250-01, 2R01DA011602-11, and 5K24DA000432-10.

  • Competing interests RDM has been a consultant for Bristol-Myers Squibb and has received research funding from Merck, Pfizer and Gilead. KAG has been a consultant and received research funding from Tibotec.

  • Ethics approval This study was conducted with the approval of the Johns Hopkins University School of Medicine Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.