Venue-based comparison of STD prevalence rates among MSM, 2000-2006

Background: MSM are at high-risk for STD infection in the United States. Identifying high-yield settings to screen MSM for STDs is necessary for cost-effectiveness and program planning purposes. Methods: As part of the CDC MSM Prevalence Monitoring Project, data were routinely collected from MSM who received STD testing at three Howard Brown Health Center (HBHC) sites: primary care, STD clinic, and non-medical settings. Results: From 2000-2006, HBHC tested 11,562 MSM for STD; 4,182 (36.2%) at a primary care visit; 5,168 (44.7%) at STD clinic; and 2,212 (19.1%) at non-medical settings. Diagnosis of new syphilis infection was more likely in primary care (5.9%, 216/3674) and STD clinic (5.4%, 256/4699) versus non-medical settings (1.5%, 32/2075). Chlamydia and gonorrhea prevalence was highest in STD Clinic (7.6%, 352/4631; 12.2%, 569/4657), followed by primary care (5.3%, 98/1850; 6.1%, 112/1851), and finally non-medical settings (2.9%, 62/2111; 1.6%, 33/2114). Conclusions: These data suggest that MSM screening programs should target STD clinic and primary care venues for disease detection and control. While it does not appear that non-medical settings contribute substantially to case identification when compared to the other settings in this analysis, the prevalence of infection at these sites warrants continued screening. Further research should be conducted to better understand the role of non-medical settings in screening MSM who would not otherwise seek traditional medical care.