@article {Hiransuthikul534, author = {Akarin Hiransuthikul and Rena Janamnuaysook and Thanthip Sungsing and Jureeporn Jantarapakde and Deondara Trachunthong and Steve Mills and Ravipa Vannakit and Praphan Phanuphak and Nittaya Phanuphak}, title = {High burden of chlamydia and gonorrhoea in pharyngeal, rectal and urethral sites among Thai transgender women: implications for anatomical site selection for the screening of STI}, volume = {95}, number = {7}, pages = {534--539}, year = {2019}, doi = {10.1136/sextrans-2018-053835}, publisher = {The Medical Society for the Study of Venereal Disease}, abstract = {Objective Comprehensive data on Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections to guide screening services among transgender women (TGW) are limited. We studied the burden of CT/NG infections in pharyngeal, rectal and urethral sites of Thai TGW and determined missed CT/NG diagnoses if selected site screening was performed.Methods Thai TGW were enrolled to the community-led test and treat cohort. CT/NG screening was performed from pharyngeal swab, rectal swab and urine using nucleic acid amplification test. CT/NG prevalence in each anatomical site was analysed, along with the relationships of CT/NG among the three anatomical sites.Results Of 764 TGW included in the analysis, 232 (30.4\%) had CT/NG infections at any anatomical site, with an overall incidence of 23.7 per 100 person-years. The most common CT/NG infections by anatomical site were rectal CT (19.5\%), rectal NG (9.6\%) and pharyngeal NG (8.1\%). Among 232 TGW with CT/NG infections at any anatomical site, 22\%{\textendash}94.4\% of infections would have been missed if single anatomical site testing was conducted, depending on the selected site. Among 668 TGW who tested negative at pharyngeal site, 20.4\% had either rectal or urethral infections. Among 583 TGW who tested negative at the rectal site, 8.7\% had either pharyngeal or urethral infections. Among 751 TGW who tested negative at the urethral site, 19.2\% had either pharyngeal or rectal infections.Conclusion Almost one-third of Thai TGW had CT/NG infections. All-site screening is highly recommended to identify these infections, but if not feasible rectal screening provides the highest yield of CT/NG diagnoses. Affordable molecular technologies and/or CT/NG screening in pooled samples from different anatomical sites are urgently needed.Trial registration number NCT03580512.}, issn = {1368-4973}, URL = {https://sti.bmj.com/content/95/7/534}, eprint = {https://sti.bmj.com/content/95/7/534.full.pdf}, journal = {Sexually Transmitted Infections} }