Gonorrhea and Chlamydia Case Detection Increased When Testing Increased in a Multisite US HIV Cohort, 2004-2014

HIV Research Network

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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.

Original languageEnglish (US)
Pages (from-to)409-416
Number of pages8
JournalJournal of acquired immune deficiency syndromes (1999)
Volume76
Issue number4
DOIs
StatePublished - Dec 1 2017

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Chlamydia
Neisseria gonorrhoeae
Gonorrhea
Chlamydia trachomatis
HIV
Odds Ratio
Patient Care
Logistic Models
Research

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Gonorrhea and Chlamydia Case Detection Increased When Testing Increased in a Multisite US HIV Cohort, 2004-2014. / HIV Research Network.

In: Journal of acquired immune deficiency syndromes (1999), Vol. 76, No. 4, 01.12.2017, p. 409-416.

Research output: Contribution to journalArticle

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title = "Gonorrhea and Chlamydia Case Detection Increased When Testing Increased in a Multisite US HIV Cohort, 2004-2014",
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.",
author = "{HIV Research Network} and Raifman, {Julia R.} and Gebo, {Kelly A.} and Mathews, {William Christopher} and Korthuis, {Philip Todd} and Ghanem, {Khalil G.} and Aberg, {Judith A.} and Moore, {Richard D.} and Nijhawan, {Ank E.} and Monroe, {Anne K.} and Berry, {Stephen A.}",
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AU - HIV Research Network

AU - Raifman, Julia R.

AU - Gebo, Kelly A.

AU - Mathews, William Christopher

AU - Korthuis, Philip Todd

AU - Ghanem, Khalil G.

AU - Aberg, Judith A.

AU - Moore, Richard D.

AU - Nijhawan, Ank E.

AU - Monroe, Anne K.

AU - Berry, Stephen A.

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N2 - 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.

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