Background The Health Protection Agency (HPA) in England have reported the number of sexually transmitted infections (STIs) diagnosed in men who have sex with men (MSM) continues to rise. Of note, Genitourinary medicine (GUM) clinic data for 2011 showed gonorrhoea (GC) diagnoses in MSM had increased by 61% and chlamydia (CT) diagnoses by 48% compared to 2010 figures. A number of factors may have contributed, including increased MSM screening and wider use of highly sensitive nucleic acid amplification tests (NAATs), especially when testing rectal & pharyngeal sites in MSM. In our London clinic, extragenital testing with dual GC/CT NAATs has been routine since 2009 in MSM.

Aim We hypothesise there is no true rise in incidence in MSM and that recent changes are a reflection of increased testing and widespread use of NAATs.

Methods Retrospective annual comparison of all positive MSM GC & CT infections identified by Aptima Combo2 (AC2; Gen-Probe) between 2010 & 2012. The number of GC cultures and positivity rates were also compared.

ResultsWhen comparing the positivity rates of GC & CT in MSM seen for testing at our clinics there has not been a significant rise from 2010 to 2012. Actual numbers of MSM with infections are higher; however this seems to reflect an increase in testing episodes only.

Conclusion According to GUMCAD returns our clinic cohort accounts for 13% of GC and 8% CT cases seen in English MSM; thus we would expect any dramatic increase in incidence to be reflected in our data, at least for the London area. Using our somewhat crude analysis we suggest the true increases in GC and CT infections reported among MSM in 2011 are significantly more modest than the rise suggested by HPA data, and most likely reflects the uptake nationally of 3-site NAAT screening.