Julia R Raifman1, Kelly A Gebo, William Christopher Mathews, Philip Todd Korthuis, Khalil G Ghanem, Judith A Aberg, Richard D Moore, Ank E Nijhawan, Anne K Monroe, Stephen A Berry. 1. *Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; †Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; ‡Department of Medicine, University of California San Diego School of Medicine, San Diego, CA; §Department of Medicine, Oregon Health and Science University, Portland, OR; ‖Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; and ¶Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
Abstract
OBJECTIVES: Annual screening for gonorrhea [Neisseria gonorrhoeae (NG)] and chlamydia [Chlamydia trachomatis (CT)] is recommended for all sexually active persons living with HIV but is poorly implemented. Studies demonstrating no increases in NG and/or CT (NG/CT) case detection in clinics that successfully expanded NG/CT screening raise questions about this broad screening approach. We evaluated NG/CT case detection in the HIV Research Network during 2004-2014, a period of expanding testing. METHODS: We analyzed linear time trends in annual testing (patients tested divided by all patients in care), test positivity (patients positive divided by all tested), and case detection (the number of patients with a positive result divided by all patients in care) using multivariate repeated measures logistic regression. We determined trends overall and stratified by men who have sex with men (MSM), men who have sex exclusively with women, and women. RESULTS: Among 15,614 patients (50% MSM, 26% men who have sex exclusively with women, and 24% women), annual NG/CT testing increased from 22% in 2004 to 60% in 2014 [adjusted odds ratio (AOR) per year 1.22 (1.21-1.22)]. Despite the increase in testing, test positivity also increased [AOR per year 1.10 (1.07-1.12)], and overall case detection increased from 0.8% in 2004 to 3.9% in 2014 [AOR per year 1.20 (1.17-1.22)]. Case detection was highest among MSM but increased over time among all 3 groups. CONCLUSIONS: NG/CT case detection increased as testing expanded in the population. This supports a broad approach to NG/CT screening among persons living with HIV to decrease transmission and complications of NG/CT and of HIV.
OBJECTIVES: Annual screening for gonorrhea [Neisseria gonorrhoeae (NG)] and chlamydia [Chlamydia trachomatis (CT)] is recommended for all sexually active persons living with HIV but is poorly implemented. Studies demonstrating no increases in NG and/or CT (NG/CT) case detection in clinics that successfully expanded NG/CT screening raise questions about this broad screening approach. We evaluated NG/CT case detection in the HIV Research Network during 2004-2014, a period of expanding testing. METHODS: We analyzed linear time trends in annual testing (patients tested divided by all patients in care), test positivity (patients positive divided by all tested), and case detection (the number of patients with a positive result divided by all patients in care) using multivariate repeated measures logistic regression. We determined trends overall and stratified by men who have sex with men (MSM), men who have sex exclusively with women, and women. RESULTS: Among 15,614 patients (50% MSM, 26% men who have sex exclusively with women, and 24% women), annual NG/CT testing increased from 22% in 2004 to 60% in 2014 [adjusted odds ratio (AOR) per year 1.22 (1.21-1.22)]. Despite the increase in testing, test positivity also increased [AOR per year 1.10 (1.07-1.12)], and overall case detection increased from 0.8% in 2004 to 3.9% in 2014 [AOR per year 1.20 (1.17-1.22)]. Case detection was highest among MSM but increased over time among all 3 groups. CONCLUSIONS:NG/CT case detection increased as testing expanded in the population. This supports a broad approach to NG/CT screening among persons living with HIV to decrease transmission and complications of NG/CT and of HIV.
Authors: Richard Teague; Anne Mijch; Christopher K Fairley; Mohsin Sidat; Kerrie Watson; Kerri Boyd; Marcus Y Chen Journal: Int J STD AIDS Date: 2008-03 Impact factor: 1.359
Authors: Marlies Heiligenberg; Maarten F Schim van der Loeff; Henry J C de Vries; Arjen G C L Speksnijder; Suzanne E Geerlings; Roel Coutinho; Maria Prins; Jan M Prins Journal: AIDS Date: 2012-03-13 Impact factor: 4.177
Authors: Marlies Heiligenberg; Paulien R Wermeling; Martijn S van Rooijen; Anouk T Urbanus; Arjen G C L Speksnijder; Titia Heijman; Maria Prins; Roel A Coutinho; Maarten F Schim van der Loeff Journal: Sex Transm Dis Date: 2012-07 Impact factor: 2.830
Authors: Gunter Rieg; Roger J Lewis; Loren G Miller; Mallory D Witt; Mario Guerrero; Eric S Daar Journal: AIDS Patient Care STDS Date: 2008-12 Impact factor: 5.078
Authors: Manuel Arias; Dan Jang; Jodi Gilchrist; Kathy Luinstra; Jenny Li; Marek Smieja; Max A Chernesky Journal: Sex Transm Dis Date: 2016-02 Impact factor: 2.830
Authors: K H Mayer; C O'Cleirigh; M Skeer; C Covahey; E Leidolf; R Vanderwarker; S A Safren Journal: Sex Transm Infect Date: 2009-08-30 Impact factor: 3.519
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: Susan Tuddenham; Khalil G Ghanem; Kelly A Gebo; Richard D Moore; William Christopher Mathews; Allison Agwu; Kenneth Mayer; Christina Schumacher; Julia Raifman; Stephen A Berry Journal: Sex Transm Infect Date: 2019-04-06 Impact factor: 3.519
Authors: Jodie Dionne-Odom; Andrew O Westfall; Julia C Dombrowski; Mari M Kitahata; Heidi M Crane; Michael J Mugavero; Richard D Moore; Maile Karris; Katerina Christopoulos; Elvin Geng; Kenneth H Mayer; Jeanne Marrazzo Journal: Clin Infect Dis Date: 2020-12-03 Impact factor: 9.079
Authors: Jodie Dionne-Odom; Andrew O Westfall; Barbara Van Der Pol; Karen Fry; Jeanne Marrazzo Journal: Sex Transm Dis Date: 2018-11 Impact factor: 2.830
Authors: Matthew A Spinelli; Hyman M Scott; Eric Vittinghoff; Albert Y Liu; Alicia Morehead-Gee; Rafael Gonzalez; Susan P Buchbinder Journal: Open Forum Infect Dis Date: 2018-05-04 Impact factor: 3.835
Authors: J Leenen; C J P A Hoebe; R P Ackens; D Posthouwer; I H M van Loo; P F G Wolffs; N H T M Dukers-Muijrers Journal: BMC Infect Dis Date: 2020-12-04 Impact factor: 3.090
Authors: Maria C Geba; Samuel Powers; Brooke Williams; Kathryn R Dort; Elizabeth T Rogawski McQuade; Kathleen A McManus Journal: Open Forum Infect Dis Date: 2022-07-01 Impact factor: 4.423
Authors: Ruth J Geller; Michele R Decker; Adebola A Adedimeji; Kathleen M Weber; Seble Kassaye; Tonya N Taylor; Jennifer Cohen; Adaora A Adimora; Lisa B Haddad; Margaret Fischl; Sarah Cunningham; Elizabeth T Golub Journal: J Womens Health (Larchmt) Date: 2020-09-30 Impact factor: 2.681