Characterizing the men who have sex with men (MSM) client populations of Washington (WA) State IPP (Infertility Prevention Project) STD & family planning/reproductive health (FP/RH) clinics using universal CT screening data, 2003-2012

Background: Chlamydia (CT) screening is recommended for males attending STD clinics, but diagnostic testing for high-risk males i.e. MSM in FP/RH clinics. WA implemented universal CT screening for men <30 years in STD and FP/RH sites from 2003-2012. This study assesses demographic and individual-level risk factors associated with CT positivity (CT+) among universally screened MSM aged <30 in WA IPP FP/RH and STD clinics.

Methods: 9,645 CT screening tests were accessed from MSM at WA FP/RH and STD clinics, 2003-2012. Diagnostic tests, i.e. signs, symptoms, STI exposure or infection, were excluded. Frequency distributions and cross-tabs were computed for demographics, behavioral risk factors (multiple/new sex partner(s), [mnsp] past 60 days; and CT test result.

Results: STD clinics represented 74% of the tests. Overall CT+=9% and a difference between site CT+ 10% (FP/RH) and 9% (STD).  Among FP/RH records, 40% were 20-24 years (CT+=11%), 20% were 18-19 years (CT+=11%), 22% were ≥ 25 years (CT+=10%), and 44% mnsp (CT+=10%). Among STD records, 40% were 20-24 years (CT+= 9%), 6% were 18-19 years (CT+=9%), 53% were ≥ 25 years (CT+=9%) and 57% mnsp (CT+=9%). CT+ was higher among ages 18-19 years and 20-24 years reporting mnsp: 12% and 11% in FP/RH vs. 11% and 9% in STD clinics.

Conclusions: MSMs tested in WA FP/RH clinics had higher CT+ by age and mnsp vs. STD MSMs. With shrinking STD resources, results support opportunities for FP/RH clinics to reach clients at increased STD risk and the importance of collecting sexual partner preference during clinic encounters.