Each year in the United States, there are more than 1 million new gonorrhea and chlamydia infections. Although most gonorrhea and chlamydia infection are found in female adolescents and young women, increases in these infections in men who have sex with men (MSM) have been documented. Rising rates of gonorrhea and chlamydia in MSM are concerning because urethral, rectal, or pharyngeal infections may increase the risk for HIV infection (if HIV-uninfected), and may increase HIV transmission to others (if already HIV-infected).
Many factors contribute to the high number of infections, but one factor in particular is relevant to clinicians. Most rectal and pharyngeal infections are asymptomatic and providers generally limit screening to urine-based tests, which fail to detect nongenital infections. Studies have found that more than 60% of gonorrhea infections and more than 50% of chlamydia infections are extra- genital, serving as reservoirs of infection and increasing the likelihood of further transmission.
This commentary by Dr. Gail Bolan reviews how to appropriately screen and treat sexually active MSM for rectal and pharyngeal gonorrhea and rectal chlamydia infections:
Keywords: [Sexual History]