BACKGROUND: Testing women for urogenital Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) is common in sexually transmitted disease (STD) clinics. However, women may not be routinely tested for rectal GC/CT. This may lead to missed infections in women reporting anal intercourse (AI). METHODS: This was a retrospective review of all women who underwent rectal GC/CT testing from August 2012 to June 2013 at an STD clinic in Columbus, Ohio. All women who reported AI in the last year had a rectal swab collected for GC/CT nucleic acid amplification testing (n=331). Using log-binomial regression models, we computed unadjusted and adjusted associations for demographic and behavioral factors associated with rectal GC/CT infection. RESULTS: Participants (n=331) were 47% African-American, with median age of 29 years. Prevalence of rectal GC was 6%, rectal CT was 13%, and either rectal infection was 19%. Prevalence of urogenital GC and CT was 7% and 13% respectively. Among women with rectal GC, 14% tested negative for urogenital GC. Similarly, 14% of women with rectal CT tested negative for urogenital CT. In unadjusted analyses, there was increased rectal GC prevalence among women reporting sex in the last year with an injection drug user, with a person exchanging sex for drugs or money, with anonymous partners, and while intoxicated/high on alcohol or illicit drugs. After multivariable adjustment, no significant associations persisted, but a trend of increased rectal GC prevalence was observed for women <26 years of age (p=0.06) and those reporting sex while intoxicated/high on alcohol or drugs (p=0.05). For rectal CT, only age <26 years was associated with prevalent infection in unadjusted models; this association strengthened after multivariable adjustment (prevalence ratio: 6.03; 95% confidence interval: 2.29-15.90). CONCLUSION: Nearly one in five women who reported AI in the last year had rectal GC or CT infection. Urogenital testing alone would have missed 14% of rectal infections. Standardized guidelines would increase rectal GC/CT testing in women and help detect missed infections.
BACKGROUND: Testing women for urogenital Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) is common in sexually transmitted disease (STD) clinics. However, women may not be routinely tested for rectal GC/CT. This may lead to missed infections in women reporting anal intercourse (AI). METHODS: This was a retrospective review of all women who underwent rectal GC/CT testing from August 2012 to June 2013 at an STD clinic in Columbus, Ohio. All women who reported AI in the last year had a rectal swab collected for GC/CT nucleic acid amplification testing (n=331). Using log-binomial regression models, we computed unadjusted and adjusted associations for demographic and behavioral factors associated with rectal GC/CTinfection. RESULTS:Participants (n=331) were 47% African-American, with median age of 29 years. Prevalence of rectal GC was 6%, rectal CT was 13%, and either rectal infection was 19%. Prevalence of urogenital GC and CT was 7% and 13% respectively. Among women with rectal GC, 14% tested negative for urogenital GC. Similarly, 14% of women with rectal CT tested negative for urogenital CT. In unadjusted analyses, there was increased rectal GC prevalence among women reporting sex in the last year with an injection drug user, with a person exchanging sex for drugs or money, with anonymous partners, and while intoxicated/high on alcohol or illicit drugs. After multivariable adjustment, no significant associations persisted, but a trend of increased rectal GC prevalence was observed for women <26 years of age (p=0.06) and those reporting sex while intoxicated/high on alcohol or drugs (p=0.05). For rectal CT, only age <26 years was associated with prevalent infection in unadjusted models; this association strengthened after multivariable adjustment (prevalence ratio: 6.03; 95% confidence interval: 2.29-15.90). CONCLUSION: Nearly one in five women who reported AI in the last year had rectal GC or CTinfection. Urogenital testing alone would have missed 14% of rectal infections. Standardized guidelines would increase rectal GC/CT testing in women and help detect missed infections.
Authors: T C Quinn; S E Goodell; E Mkrtichian; M D Schuffler; S P Wang; W E Stamm; K K Holmes Journal: N Engl J Med Date: 1981-07-23 Impact factor: 91.245
Authors: Marjan Javanbakht; Pamina Gorbach; Ali Stirland; Michael Chien; Peter Kerndt; Sarah Guerry Journal: Sex Transm Dis Date: 2012-12 Impact factor: 2.830
Authors: Joy D Scheidell; Typhanye P Dyer; MacRegga Severe; Yazmeen E Tembunde; Kailyn E Young; Maria R Khan Journal: Perspect Sex Reprod Health Date: 2020-02-24
Authors: Courtney Gallagher; Susan S Lee; Frances S Shofer; Cynthia J Mollen; Monika K Goyal; Nadia L Dowshen Journal: Pediatr Emerg Care Date: 2020-11 Impact factor: 1.602
Authors: Geneviève A F S van Liere; Martijn S van Rooijen; Christian J P A Hoebe; Titia Heijman; Henry J C de Vries; Nicole H T M Dukers-Muijrers Journal: PLoS One Date: 2015-10-29 Impact factor: 3.240
Authors: Nicole H T M Dukers-Muijrers; Julius Schachter; Genevieve A F S van Liere; Petra F G Wolffs; Christian J P A Hoebe Journal: BMC Infect Dis Date: 2015-11-17 Impact factor: 3.090
Authors: Philip A Chan; Ashley Robinette; Madeline Montgomery; Alexi Almonte; Susan Cu-Uvin; John R Lonks; Kimberle C Chapin; Erna M Kojic; Erica J Hardy Journal: Infect Dis Obstet Gynecol Date: 2016-06-05