Screening for Asymptomatic Extragenital Gonorrhea and Chlamydia in Men Who Have Sex with Men: Significance, Recommendations, and Options for Overcoming Barriers to Testing
Screening for Asymptomatic Extragenital Gonorrhea and Chlamydia in Men Who Have Sex with Men: Significance, Recommendations, and Options for Overcoming Barriers to Testing
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DOI：
10.1089/lgbt.2014.0056
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发表时间：
2015-03-01
期刊：
影响因子：
4.8
通讯作者：
Lutz, Anthony R.
中科院分区：
文献类型：
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作者：
Lutz, Anthony R.
根据疾病控制和预防中心(CDC)的数据，男男性行为者(MSM)感染沙眼衣原体(CT)和淋病奈瑟菌(GC)的风险比其他人群高得不成比例，这两种疾病是美国最常见的两种应报告疾病。这两种疾病中的任何一种都是感染和传播人类免疫缺陷病毒(艾滋病毒)的重要风险因素。最近的研究表明，无论是否合并泌尿生殖道感染，MSM患者生殖器外、口咽和直肠部位均有显著的无症状GC和CT感染。然而，生殖器外部位没有常规筛查，因此，许多口咽和直肠部位的无症状GC和CT感染可能被漏诊。本文将从目前MSM生殖器外GC和CT的循证筛查建议开始。接下来是最近报告的无症状MSM生殖器外GC和CT感染率，并讨论未诊断的生殖器外GC和CT感染的风险和潜在影响。最后，对筛查的频率和潜在的障碍进行了讨论，并总结了文献中发现的提高筛查频率的潜在干预措施。审查的范围将主要集中在美国的建议、感染率和筛查频率，并纳入相关的国际建议和研究，以供比较和说明。
Men who have sex with men (MSM) have a disproportionately greater risk than other populations of acquiring Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC), the two most commonly reported notifiable diseases in the United States according to the Centers for Disease Control and Prevention (CDC). The presence of either of these diseases is a significant risk factor for the acquisition and transmission of human immunodeficiency virus (HIV). Recent studies have shown that significant rates of asymptomatic GC and CT infection are found at the extragenital oropharygeal and rectal sites in MSM, with or without concurrent urogenital infection. However, extragenital sites are not being routinely screened and, thus, many asymptomatic GC and CT infections at the oropharyngeal and rectal sites may go undiagnosed.This review will begin with the current evidence-based screening recommendations for extragenital GC and CT in MSM. This will be followed by recently reported extragenital GC and CT infection rates in asymptomatic MSM, and a discussion of the risks and potential implications of undiagnosed extragenital GC and CT infections. Finally, a discussion on the frequency of, and potential barriers to, screening will be presented with a summary of potential interventions for increasing screening frequency found in the literature. The scope of this review will focus primarily on U.S. recommendations, infection rates, and screening frequencies, with the inclusion of relevant international recommendations and studies for comparative and illustrative purposes.