Sex Transm Dis. 2022 Dec 14. doi: 10.1097/OLQ.0000000000001743. Online ahead of print.
ABSTRACT
BACKGROUND: The 2021 CDC STI treatment guidelines recommend extragenital testing for gonorrhea and chlamydia in men who have sex with men (MSM) and for women based on reported behaviors and exposures. The “IWantTheKit (IWTK)” program is a free online platform for specimen self-collection and mail-in for combined chlamydia/gonorrhea testing. We sought to assess the additional diagnostic value of extragenital testing compared to genital testing only for chlamydia/gonorrhea and determine factors associated with a positive extragenital test among IWTK users.
METHODS: From August 2013 to January 2022, 7,612 unique IWTK users returned swabs for testing; 3,407 (45%) users requested both genital and extragenital tests and were included in this analysis. Descriptive statistics summarized demographic characteristics, reported behaviors, and genital and extragenital test results, data were stratified by gender and age group. A logistic regression model was used to estimate associations between factors and extragenital STI positivity.
RESULTS: Chlamydia positivity was 4.7%, 2.4% and 1.5% at genital, extragenital and both sites were positive, respectively; for gonorrhea, 0.4%, 1.1% and 0.4% were positive at those sites, respectively. Among women, age 25 and younger was significantly associated with extragenital chlamydia, OR = 4.0 (p = 0.010). Being in high risk quiz score group was associated with extragenital chlamydia (OR = 2.6, p = 0.005), and extragenital gonorrhea in men and women (OR = 8.5, p = 0.005).
CONCLUSION: Extragenital testing detected additional chlamydia and gonorrhea cases in the IWTK user population that would have been missed by genital only testing, especially for females <25 years and people reported high risk.
PMID:36729630 | DOI:10.1097/OLQ.0000000000001743
