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Home >> Publications >> Increased gonorrhoea and chlamydia testing did not increase case detection in an HIV clinical cohort 1999-2007.

Publication

Author(s):

Berry SA, Ghanem KG, Page KR, Gange SJ, Thio CL, Moore RD, Gebo KA.

Pub Title:

Increased gonorrhoea and chlamydia testing did not increase case detection in an HIV clinical cohort 1999-2007.

Pub Date:

Oct 31 2011

Journal Issue:

6

Page Number:
469-75

Journal:

Title: 
Sexually Transmitted Infections (BMJ) Infect
Link: 
http://sti.bmj.com/content/87/6/469.long

PubMed: 21745834
Pub PDF: PDF icon 21745834.pdf

Abstract
OBJECTIVES
: Since 2003, US organisations have recommended universal screening, rather than targeted screening, of HIV-infected persons for gonorrhoea and chlamydia. The objective of this study was to determine whether wider testing resulting from these guidelines would produce an increase in gonorrhoea/chlamydia diagnoses.

METHODS: 3283 patients receiving HIV care in 1999-2007 in the Johns Hopkins Hospital HIV clinic were studied. The two primary outcomes were the occurrence of any gonorrhoea/chlamydia testing in each year of care and the occurrence of any positive result(s) in years of testing. The proportion of all patients in care who were diagnosed with gonorrhoea/chlamydia was defined as the number of patients with positive results divided by the number of patients in care. Trends were analysed with repeated measures logistic regression.

RESULTS: The proportion of patients tested for gonorrhoea/chlamydia increased steadily from 0.12 in 1999 to 0.33 in 2007 (OR per year for being tested 1.17, 95% CI 1.15 to 1.19). The proportion positive among those tested decreased significantly after 2003 (OR per year 0.67, 95% CI 0.55 to 0.81). The proportion of all patients in care diagnosed with gonorrhoea/chlamydia therefore remained generally stable in 1999-2007 (OR per year 0.97, 95% CI 0.91 to 1.04).

CONCLUSIONS: Universal annual screening, as implemented, did not increase the proportion of all patients in care who were diagnosed with gonorrhoea/chlamydia. Similarly low implementation rates have been reported in cross-sectional studies. If future efforts to enhance implementation do not yield increases in diagnoses, then guidelines focusing on targeted screening of high-risk groups rather than universal screening may be warranted.

PMID: 21745834 [PubMed - indexed for MEDLINE]

PMCID: PMC3174330

 
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Citation:

Berry SA, Ghanem KG, Page KR, Gange SJ, Thio CL, Moore RD, Gebo KA. Increased gonorrhoea and chlamydia testing did not increase case detection in an HIV clinical cohort 1999-2007. Sex Transm Infect. 2011 Oct;87(6):469-75. doi: 10.1136/sextrans-2011-050051. Epub 2011 Jul 11. PubMed PMID: 21745834; PubMed Central PMCID: PMC3174330.