What would be missed if we didn’t screen men who have sex with men for oral chlamydia trachomatis? A cross-sectional study
Priya Loomba A D , Vickie Knight A B and Anna McNulty A CA Sydney Sexual Health Centre, South East Sydney Local Health District, Sydney, NSW 2000, Australia.
B The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia.
C School of Public Health and Community Medicine, University of NSW, Kensington, NSW 2052, Australia.
D Corresponding author. Email: Priya.Loomba@sesiahs.health.nsw.gov.au
Sexual Health 13(2) 196-198 https://doi.org/10.1071/SH15209
Submitted: 26 October 2015 Accepted: 18 December 2015 Published: 18 February 2016
Abstract
Background: This study aimed to describe oropharyngeal chlamydia (OCT) in gay and bisexually active men (GBM) attending a large urban sexual health clinic in Sydney and determine what proportion of cases would be missed if screening was not routine. Methods: Retrospective data were extracted for all GBM with a positive OCT result between 1 October 2012 and 31 April 2014. The control group consisted of patients who had a negative OCT result on their first visit during the study period, and each patient was only counted once. Results: A total of 74 of 2920 GBM (0.03, 95% CI: 0.02–0.03) were diagnosed with OCT. The 2920 GBM had a total of 11 226 OCT tests performed, demonstrating OCT test positivity of 0.006 (95% CI: 0.005–0.008). A total of 62 sexually transmissible infections (STIs) were diagnosed at other sites: 34 rectal chlamydia (CT), 12 throat gonorrohea (GC), 7 urine CT, 7 rectal GC, 1 infectious syphilis and 1 non-gonoccal urethritis (NGU) case. Of the 74 OCT cases, 56 (0.76, 95% CI: 0.64–0.85) were treated with Azithromycin; 51 (69%) as part of standard treatment for their STI co-infection (34 rectal CT, 12 throat GC, 7 urine CT, 7 rectal GC, 1 NGU case) and a further five (7%) were treated as contacts. The remaining 18 people (0.24, 95% CI: 0.15–0.36) would not have been treated unless they were tested specifically for OCT. Conclusion: Overall, two-thirds of the OCT cases received appropriate treatment and only a small number of cases would have been missed had routine screening not been performed. With an extremely low overall test positivity of 0.6%, screening for OCT at our service adds little to population level health control.
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