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
- 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.