CHICAGO — Despite visiting a sexual health clinic for screening tests, up to 35% of sexually active gay men might still have undiagnosed gonorrhea infections, Kristen Mahle said at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention.
The undiagnosed rectal infections, as well as undiagnosed gonorrhea infections of the pharynx and urethra, occur because many clinics don't routinely screen asymptomatic men at all possible sites of exposure, said Ms. Mahle of the Centers for Disease Control and Prevention. “[Most] gonorrhea infections at nongenital sites are asymptomatic. Clinics conducting routine gonorrhea screenings for sexually active men who have sex with men should screen based on behavior, not just on symptoms.”
Her analysis drew on data from the Men Who Have Sex With Men Prevalence Monitoring Project. This 4-year study included data on 89,500 visits to STD and gay men's health clinics in eight U.S. cities. Participants were aged 15–65 years.
In all tested men—symptomatic and asymptomatic—the urethral gonorrhea rate was 1%, the rectal gonorrhea rate was 5%, and that of pharyngeal gonorrhea, 3%.
Almost half of the men (48%) were asymptomatic at their clinic visit, yet 7% of the urethral infections, 26% of the rectal infections, and 11% of the pharyngeal infections were in that group. However, only 52% of asymptomatic men who reported exposure were tested at all three sites. Most of those reporting urethral exposure were tested at the urethra (91%), but only 64% of those reporting rectal exposure received rectal testing, and 74% of those reporting pharyngeal exposure received pharyngeal testing. Ms. Mahle concluded 9% of the urethral infections, 35% of the rectal infections, and 25% of the pharyngeal infections went undiagnosed.