Program Schedule

1750
Prevalence of Non-Genital Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT) among Men and Women Tested on the Basis of Sexual Exposure at an Urban Sexually Transmitted Diseases Clinic

Session: Poster Abstract Session: Sexually Transmitted Infections: Epidemiology, Screening, and Management
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • 1750_IDWPOSTER.pdf (133.8 kB)
  • Background: Current guidelines recommend screening for rectal GC and CT and pharyngeal GC only in men having sex with men (MSM).  We sought to determine the incidence of GC and CT based on anatomic exposure (oral, anal or genital) in all men and women.

    Methods: In 2012-13 the Kansas City Health Department STD clinic screened all men and women for GC and CT according to anatomic site of sexual exposure.  Pharyngeal and rectal swabs were collected utilizing the Aptima unisex swab specimen collection kit, and performed at the Missouri Department of Health and Senior Services.  We report the result of pharyngeal and rectal GC and CT among MSM, bisexual men, men having sex with women (MSW), women having sex with men (WSM), women having sex with women (WSW), and bisexual women.

    Results:

    3832 men and women engaged in oral or anal sex.  The rates of pharyngeal, rectal and urogenital GC and CT among this group are [results expressed as number positive/number exposed (percentage)] :

     

    GC

    CT

    Pharyngeal

    Rectal

    Urogenital

    Pharyngeal

    Rectal

    Urogenital

    MSW

    61/1908 (3.2)

    139/1900 (7.3)

    12/1908 (0.6)

    371/1900 (19.5)

    MSM

    47/480 (9.8)

    53/315 (16.8)

    26/480 (5.4)

    10/480 (2.1)

    63/315 (20.0)

    28/480 (5.8)

    Bisexual men

    9/157 (5.7)

    8/55 (14.6)

    8/152 (5.3)

    6/157 (3.8)

    7/55 (12.7)

    13/152 (8.2)

    WSM 

    51/1128 (4.5)

    3/100 (3.0)

    70/1095 (6.4)

    23/1128 (2.0)

    11/100 (11.0)

    139/1095 (12.7)

    WSW

    1/38 (2.6)

    1/32 (3.1)

    0/38 (0.0)

    1/32 (3.1)

    Bisexual women

    2/121 (1.7)

    1/21 (4.8)

    6/114 (5.3)

    4/121 (3.4)

    4/21 (19.1)

    10/114 (9.6)

    Among all men, 62%, 80%, 64% and 91% with pharyngeal GC, rectal GC, pharyngeal CT, and rectal CT had negative results at their genital site (urethral or urine).  Among MSW, 42% of those with pharyngeal GC tested negative at their urogenital site.  Among all women, 35%, 25%, 37% and 33% with pharyngeal GC, rectal GC, pharyngeal CT, and rectal CT had negative results at their genital site (vaginal, cervical or urine).

    Conclusion: Although rates of infection were higher in MSM, 3.2% of MSW and 4.5% of WSM had pharyngeal GC.  11.0% and 3.0% of WSM had rectal CT and GC, respectively.  Many MSW and women would have been missed if oral and rectal testing had not been performed.  We recommend that STD guidelines for screening at non-genital sites include exposed women and MSW.

    Georgia Graham, University of Missouri-Kansas City, Kansas City, MO, Lesha Dennis, Kansas City Missouri Department of Health, Kansas City, MO and David Bamberger, MD, UMKC School of Medicine, Kansas City, MO

    Disclosures:

    G. Graham, None

    L. Dennis, None

    D. Bamberger, None

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