142nd APHA Annual Meeting and Exposition

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305821
Missed Opportunities for Gonorrhea and Chlamydia Screening in Men who have Sex with Men (MSM)

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Chris Daunis, MSAS , Department of Health and Hospitals Louisiana Office of Public Health STD/HIV Program, New Orleans, LA
Kathleen Welch, PhD, MPH, MA , Department of Health and Hospitals Louisiana Office of Public Health STD/HIV Program, New Orleans, LA
Megha Upadhyaya, MPH , Department of Health and Hospitals Louisiana Office of Public Health STD/HIV Program, New Orleans, LA
Background:This study highlights the need to provide gonorrhea and Chlamydia extragenital screenings for MSM since the vast majority of these infections would be undiagnosed if only a urine screening was conducted.

 Methods:A retrospective analysis of MSM who attended five MSM Wellness Centers in Louisiana from 2012-2013 was conducted. The inclusion criteria were MSM who were screened for urethral, rectal, and pharyngeal Chlamydia and gonorrhea at any visit to the Wellness Center. The urethral, rectal and pharyngeal positivity for Chlamydia and gonorrhea was calculated. The proportion of Chlamydia or gonorrhea infections that would have been missed by urine screen only was calculated.

Results:During 2012-2013, 552 visits were made by clients to the MSM Wellness Centers.  1,113 tests were administered for gonorrhea and Chlamydia at all three anatomical sites. Of those tests, 57 (5%) resulted in a positive result for Chlamydia or gonorrhea in one or more of the three anatomical sites. Most MSM who were diagnosed with gonorrhea or Chlamydia were infected in the rectum or pharynx (75%). The prevalence of infection varied by anatomical site (rectal, 44%; pharyngeal, 32%, and urethral, 24%). If only urine screenings were performed, 43 positive infections (75%) would have been missed.  

Conclusions: This study shows that the majority of gonorrhea and Chlamydia diagnoses among MSM are missed when only a urine screening is performed. The Louisiana Office of Public Health is working with the Louisiana State Laboratory to include extragenital screenings for gonorrhea and Chlamydia as a clinical standard at clinics serving MSM.

Learning Areas:

Advocacy for health and health education
Diversity and culture
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Describe the need to provide gonorrhea and Chlamydia extragenital screenings for MSM.

Keyword(s): STDs/STI, Lesbian, Gay, Bisexual and Transgender (LGBT)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Wellness Center Project Coordinator and responsible for the implementation of the intervention described in the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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