Chlamydia and Gonorrhea Incidence and Testing among Patients in the HIV Outpatient Study, 2007-2017.

Abstract

BACKGROUND Although chlamydia (CT) and gonorrhea (GC) infections are increasing in the United States, there are limited data on their incidence, testing rates and associated risk factors among persons with HIV (PWH), including by anatomic site among men who have sex with men (MSM). METHODS We analyzed 2007-2017 medical record data from HIV Outpatient Study participants in care at nine HIV clinics. We calculated CT (and GC) incidence and testing rates and assessed associations with sociodemographic and clinical factors using log-linear regression. RESULTS Among 4,727 PWH, 397 had 881 CT infections and 331 had 861 GC infections, with incidence of 2.95 and 2.88 per 100 person-years, respectively. From 2007-2017, incidence and testing rates increased by approximately 3.0- and 1.9-fold for CT and GC, respectively. Multivariable factors associated with incident CT (GC) included younger age, MSM, and prior diagnoses of sexually transmitted diseases (STDs). Among 1,159 MSM, 583 (50.3%) had 844 CT and 843 GC tests during 2016-2017, and 26.6% of tests were 3-site (urethra, rectum, and pharynx), yielding the highest rates of CT (GC) detection. Multivariable factors associated with CT (GC) testing included younger age, non-Hispanic/Latino black race, and having prior STDs. CONCLUSIONS Recent CT and GC incidence and testing increased among PWH; however, only half of MSM were tested for CT or GC during 2016-2017 and < 1/3 of tests were 3-site. To promote sexual health and STD prevention among PWH, including MSM, research regarding the added value of CT and GC testing across three anatomic sites is needed.