Gonorrhea and Chlamydia Testing Rates of HIV-Infected Men: Low Despite Guidelines

Noting that gonorrhea (GC) and chlamydia (CT) screening for HIV-infected men "may decrease HIV transmission and reduce the incidence of pelvic inflammatory disease in female partners," the study authors determined GC/CT testing rates in a clinical HIV cohort before and after 2003, when CDC issued guidelines for GC/CT screening.

First GC/CT testing episodes were identified for all men enrolling in a Baltimore HIV clinic from 1999 to 2007. Clinical and demographic factors associated with being tested and with having a positive result were assessed using multivariate Cox and logistic regression.

Of 1,110 male participants, the rate of GC/CT testing upon clinic enrollment increased from 4.0 percent prior to 2003 to 16.5 afterwards, while the rate of ever being tested increased from 34.2 percent to 49.1 percent (p<0.001 for both comparisons). Among men with same-sex contact, extragenital sites were included for 10 percent of first testing episodes. Among the 342 men ever tested, 5.2 percent had positive results for their first test. Predictors of testing included enrollment after 2003, younger age, frequent visits, and black race. Positive test result predictors included CD4 count =200 cells/mm3 and younger age.

"GC/CT testing rates among men increased substantially after the 2003 guidelines but remain low," the authors concluded. "Disseminating existing evidence for GC/CT screening and promoting operational interventions to facilitate it are warranted."