Douglas Claudia M, O'Leary Sonja C, Tomcho Margaret M, Wu Florence J, Penny Lara, Federico Steven G, Wilson Michael L, Rinehart Deborah J, Frost Holly M
Sex Transm Dis. 2021 Mar 1;48(3):161-166. doi: 10.1097/OLQ.0000000000001302.
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infection rates continue to rise. Screening guidelines have largely focused on sexually active female individuals and men who have sex with men populations. Health care system testing and infection rates, particularly among heterosexual male individuals, are poorly understood. Our aim was to evaluate CT and GC testing and prevalence among 12- to 24-year-old patients in an urban federally qualified health center system.
This retrospective study analyzed electronic health record data from 2017 to 2019 in a large system of federally qualified health centers in Denver, CO. Abstracted data included demographics, sexual activity, sexual orientation, and laboratory results. χ2 Tests were used to evaluate differences between groups.
Of the 44,021 patients included, 37.6% were tested, 15.0% were positive for CT, and 3.4% were positive for GC. Heterosexual male patients had a testing rate of 22.8% and positivity rates of CT and GC at 13.1% and 3.0%, respectively. Among tested patients documented as not sexually active, 7.5% were positive for CT. Multiple or reinfections were detected in 29% of patients.
This study shows low testing rates and high rates of CT and GC infections among all patients, including heterosexual male patients and those documented as not sexually active. Improved screening of these populations in the primary care setting may be key to combating the sexually transmitted disease epidemic.
沙眼衣原体（CT）和淋病奈瑟菌（GC）感染率持续上升。筛查指南主要集中在性活跃女性个体和男男性行为人群。医疗保健系统的检测情况及感染率，尤其是异性恋男性个体中的情况，了解甚少。我们的目的是评估科罗拉多州丹佛市一个城市联邦合格医疗中心系统中12至24岁患者的CT和GC检测情况及患病率。
这项回顾性研究分析了2017年至2019年科罗拉多州丹佛市一个大型联邦合格医疗中心系统的电子健康记录数据。提取的数据包括人口统计学信息、性活动、性取向和实验室检查结果。采用χ2检验评估组间差异。
纳入的44,021名患者中，37.6%接受了检测，15.0%的CT检测呈阳性，3.4%的GC检测呈阳性。异性恋男性患者的检测率为22.8%，CT和GC的阳性率分别为13.1%和3.0%。在记录为无性活动的检测患者中，7.5%的CT检测呈阳性。29%的患者检测到多次感染或再感染。
本研究表明，所有患者，包括异性恋男性患者和记录为无性活动的患者，检测率较低，CT和GC感染率较高。在初级保健环境中改善对这些人群的筛查可能是抗击性传播疾病流行的关键。
