Gonorrhea and Chlamydia Case Detection Increased When Testing Increased in a Multisite US HIV Cohort, 2004-2014

Area of Science:

• Infectious Diseases
• Public Health
• HIV Medicine

Background:

• Annual screening for gonorrhea [Neisseria gonorrhoeae (NG)] and chlamydia [Chlamydia trachomatis (CT)] is recommended for sexually active individuals living with HIV.
• Implementation of this screening remains a challenge.
• Previous studies questioned the broad screening approach due to inconsistent increases in case detection.

Purpose of the Study:

• To evaluate the trends in gonorrhea and chlamydia case detection within the HIV Research Network between 2004 and 2014.
• To assess the impact of expanding gonorrhea and chlamydia testing on case detection rates among people living with HIV.

Main Methods:

• Analysis of linear time trends in annual testing, test positivity, and case detection.
• Utilized multivariate repeated measures logistic regression.
• Stratified analysis by men who have sex with men (MSM), men who have sex exclusively with women, and women.

Main Results:

• Annual gonorrhea and chlamydia testing increased significantly from 22% in 2004 to 60% in 2014.
• Despite increased testing, test positivity also rose.
• Overall case detection for gonorrhea and chlamydia increased from 0.8% to 3.9% during the study period, with the highest rates among MSM, but significant increases observed across all groups.

Conclusions:

• Expanded gonorrhea and chlamydia screening in individuals with HIV is associated with increased case detection.
• These findings support a broad screening strategy to mitigate the transmission and complications of gonorrhea, chlamydia, and HIV.