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Rectal infection with Neisseria gonorrhoeae and Chlamydia trachomatis in males in the United States

  1. Barbara A. Body3
  1. 1Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
  2. 2DHAP, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
  3. 3Laboratory Corporation of America Holdings, Burlington, NC
  1. Corresponding author: Guoyu Tao, Ph.D, Centers for Disease Control, 1600 Clifton Road, Atlanta, GA 30333, e-mail: gat3{at}cdc.gov

Abstract

Background. The CDC guidelines recommend at least annual rectal screening of men who have receptive anal intercourse for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT). Only limited national data are available on the prevalence of rectal GC and CT infection among U.S. men.

Methods. In collaboration with a large U.S. commercial laboratory, we estimated positivity of the first rectal GC and CT test (“index” test) in men aged 15-60 years tested between January, 2013 and May, 2015. We estimated the frequency and positivity of pharyngeal or urine specimens tested for GC and CT on the index date, and the frequency and positivity of repeat rectal testing or any follow-up testing at any anatomic site after the index date.

Results. Of 52,063 tested men aged 15-60 years, approximately 6.1% were positive for GC only, 8.3% for CT only, and 2.7% for both GC and CT on their index date. On that date, 86.5% had either urine or pharyngeal specimens collected, and 56.1% had both specimens collected. Pharyngeal GC infection was highly associated with rectal GC infection. Follow-up testing after 12 months ranged from 42.4% among uninfected men to 56.7% among infected men on the index date. Positivity was at least 5.7% in rectal GC, rectal CT, or pharyngeal GC at their last test.

Conclusions. This analysis of a large number of male rectal specimens tested for GC and CT suggest that routine testing and timely repeat rectal GC and CT testing should be prioritized among men who reported receptive rectal sex.

UNCORRECTED PROOF

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