Screening for chlamydia and gonorrhoea in men who have sex with men in clinical and non-clinical settings

Abstract

Background: There are few published data on the rate of chlamydia and gonorrhoea infection in men who have sex with men (MSM). Our aim was to determine the rate of positive chlamydia and gonorrhoea tests in this population in the Australian Capital Territory (ACT). Methods: Results of all chlamydia and gonorrhoea tests generated by Canberra Sexual Health Centre between June 2001 and September 2003, including those from outreach clinics, were reviewed (audit one). Between September 2003 and April 2004, Canberra Sexual Health Centre outreach program staff and a general practitioner with a high caseload of MSM offered screening of the throat, urethra and rectum to all MSM, irrespective of their reported participation in unprotected anal intercourse. Chlamydia and gonorrhoea test results generated during this period were reviewed (audit two). Results: In the first audit, 1086 specimens from 314 individuals were tested and 30/314 (9.6%, 95% CI 6.6–13.4) men were positive for chlamydia in one or more anatomical site. A total of 306 specimens from 118 individuals were tested for gonorrhoea. Of these, eight (6.8%, 95% CI 3.0–12.9) individuals tested positive. In the second audit, 16 of 157 men (10.2%, 95% CI 9.5–16.0) tested positive for chlamydia and 4/155 (2.6%, 95% CI 0.7–6.5) tested positive for gonorrhoea. The rectum was the most commonly infected anatomical site for both infections. The overall proportions of positive chlamydia and gonorrhoea tests were 36/471 (7.6%, 95% CI 5.4–10.4) and 12/273 (4.4%, 95% CI 2.2–7.6) respectively. Conclusions: These data, collected in a range of settings, indicate high rates of chlamydia and gonorrhoea in MSM in the ACT and provide support for annual testing, particularly of the rectum, in this population.