Infection Positivity Among Sexual Contacts to Chlamydia and Gonorrhea, STI Surveillance Network, 2021-2023.

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• Individuals with a history of sexual contact with partners diagnosed with chlamydia (CT) or gonorrhea (NG) face an elevated risk of acquiring these sexually transmitted infections (STIs).
• Current guidelines recommend presumptive antimicrobial therapy for sexual contacts, yet concerns persist regarding the potential for unnecessary antibiotic utilization.

Purpose of the Study:

• To assess the positivity rates of chlamydia (CT) and gonorrhea (NG) among sexual contacts of infected individuals.
• To evaluate the utility of point-of-care testing for optimizing antimicrobial use in this population.

Main Methods:

• A retrospective review of patient visits from January 2021 to October 2023 in 10 STI clinics.
• Analysis of CT and NG positivity rates stratified by patient groups (women, men who have sex with men [MSM], men who have sex with women only [MSW]) and symptomatic status.

Main Results:

• Overall, 11,072 (6.8%) contacts were identified with CT and/or NG. CT positivity was 35% among CT contacts, and NG positivity was 31% among NG contacts.
• CT positivity did not vary by symptomatic status across patient groups.
• NG positivity was higher in symptomatic versus asymptomatic MSM and MSW, but not in women.

Conclusions:

• A substantial proportion of sexual contacts to CT or NG were found to be infected, highlighting the need for effective screening.
• CT infection was most prevalent in MSW contacts, while NG infection was most common in women contacts.
• The observed positivity rates and the significant percentage of negative tests (~60%) suggest that point-of-care testing could enhance antimicrobial stewardship and patient care.