In the Journals

‘Missed opportunities’: Study finds low rate of STD testing among HIV-positive MSM in US

Surveillance data from six U.S. cities showed that only half of HIV-positive men who have sex with men, or MSM, were tested for chlamydia or gonorrhea during visits to HIV clinics in 2016 and 2017, and less than one-third of the screenings involved three-site testing.

Researchers said the findings demonstrate “missed opportunities” for treatment and prevention.

“Chlamydia and gonorrhea are the most commonly reported notifiable diseases in the United States. Coinfections of HIV with chlamydia and/or gonorrhea increase the risk of HIV transmission,” Jun Li, MD, PhD, MPH, an epidemiologist in the CDC’s Division of HIV/AIDS Prevention, told Infectious Disease News. “Understanding the burden of sexually transmitted diseases among people with HIV plays a critical role in promoting STD treatment and further improving HIV prevention and care.”

Li and colleagues analyzed medical record data from participants in the HIV Outpatient Study in care at nine HIV clinics between 2007 and 2017. The clinics were in Chicago; Denver; Stony Brook, New York; Philadelphia; Tampa, Florida; and Washington, D.C. According to the study, the researchers calculated chlamydia and gonorrhea incidence and testing rates, and assessed

associations with sociodemographic and clinical factors using log-linear regression.

According to Li, the results showed that rates of chlamydia and gonorrhea increased among people with HIV during from 2007 to 2017, with testing rates for chlamydia and gonorrhea also increasing across the clinics during that timeframe. However, from Oct. 1, 2016, to Sept. 30, 2017, just 50.3% of 1,158 study participants were tested for chlamydia or gonorrhea, with 26.6% of tests being three-site tests — urethra, rectum and pharynx.

“Suboptimal testing for chlamydia and gonorrhea suggests missed opportunities for prompt STD identification and treatment and, therefore, subsequent missed opportunities for HIV and STD prevention,” Li said. “Conducting genital (urine)-based testing alone appeared to miss a substantial number of anorectal and pharyngeal chlamydia and gonorrhea infections among gay and bisexual men with HIV.”

Li said the study demonstrated “the need [for] developing and implementing evidence-based interventions to promote chlamydia and gonorrhea testing, and the need [for] assessing the benefit of routine testing for chlamydia and gonorrhea across three anatomic sites.” – by Caitlyn Stulpin

Disclosures: Li reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.

Surveillance data from six U.S. cities showed that only half of HIV-positive men who have sex with men, or MSM, were tested for chlamydia or gonorrhea during visits to HIV clinics in 2016 and 2017, and less than one-third of the screenings involved three-site testing.

Researchers said the findings demonstrate “missed opportunities” for treatment and prevention.

“Chlamydia and gonorrhea are the most commonly reported notifiable diseases in the United States. Coinfections of HIV with chlamydia and/or gonorrhea increase the risk of HIV transmission,” Jun Li, MD, PhD, MPH, an epidemiologist in the CDC’s Division of HIV/AIDS Prevention, told Infectious Disease News. “Understanding the burden of sexually transmitted diseases among people with HIV plays a critical role in promoting STD treatment and further improving HIV prevention and care.”

Li and colleagues analyzed medical record data from participants in the HIV Outpatient Study in care at nine HIV clinics between 2007 and 2017. The clinics were in Chicago; Denver; Stony Brook, New York; Philadelphia; Tampa, Florida; and Washington, D.C. According to the study, the researchers calculated chlamydia and gonorrhea incidence and testing rates, and assessed

associations with sociodemographic and clinical factors using log-linear regression.

According to Li, the results showed that rates of chlamydia and gonorrhea increased among people with HIV during from 2007 to 2017, with testing rates for chlamydia and gonorrhea also increasing across the clinics during that timeframe. However, from Oct. 1, 2016, to Sept. 30, 2017, just 50.3% of 1,158 study participants were tested for chlamydia or gonorrhea, with 26.6% of tests being three-site tests — urethra, rectum and pharynx.

“Suboptimal testing for chlamydia and gonorrhea suggests missed opportunities for prompt STD identification and treatment and, therefore, subsequent missed opportunities for HIV and STD prevention,” Li said. “Conducting genital (urine)-based testing alone appeared to miss a substantial number of anorectal and pharyngeal chlamydia and gonorrhea infections among gay and bisexual men with HIV.”

Li said the study demonstrated “the need [for] developing and implementing evidence-based interventions to promote chlamydia and gonorrhea testing, and the need [for] assessing the benefit of routine testing for chlamydia and gonorrhea across three anatomic sites.” – by Caitlyn Stulpin

Disclosures: Li reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.