Tao Guoyu, Gift Thomas L
From the Division of STD Prevention (DSTDP), The Centers for Disease Control and Prevention, Atlanta, GA.
Sex Transm Dis. 2025 Sep 1;52(9):523-528. doi: 10.1097/OLQ.0000000000002165. Epub 2025 Apr 3.
Chlamydia and gonorrhea are among the most commonly reported sexually transmitted infections in the United States. Testing for chlamydia and gonorrhea infection can be conducted by anatomic site (site-specific). Monitoring testing volume and positivity by anatomic site is important.
Using a large national laboratory dataset, we assessed chlamydia and gonorrhea test volume and positivity by anatomical site in patients aged 15 to 60 years.
The data contained 45 million tests each for chlamydia and gonorrhea for 2019 to 2023. Of chlamydia tests, 71.6% were for women. Among women, 0.4%, 1.5%, and 98.1% were performed on rectal, pharyngeal, and urogenital specimens; chlamydia positivity rates were 7.3%, 2.0%, and 4.3%, respectively. Among men, 10.5%, 13.7%, and 75.8% were performed on rectal, pharyngeal, and urogenital specimens; chlamydia positivity rates were 8.0%, 1.4%, and 6.3%, respectively. Among people aged 15 to 24 years, chlamydia positivity was 12.8% for rectal, 3.4% for pharyngeal, and 8.7% for urogenital among women, and 11.6%, 2.4%, and 12.2% among men, respectively. Gonorrhea testing volume overall and by age and sex was similar to that of chlamydia. Gonorrhea rectal, pharyngeal, and urogenital positivity rates were 3.2%, 2.4%, and 1.0% among women; 6.8%, 5.2%, and 3.3% among men; and 4.3%, 3.0%, and 1.6% among women aged 15 to 24 years, and 10.5%, 7.2%, and 4.6% among men aged 15 to 24 years, respectively.
Although men accounted for <30% of overall chlamydia and gonorrhea testing, they accounted for a majority of extragenital testing. High rates of chlamydia and gonorrhea positivity by specimen type among many demographic groups, especially for extragenital specimens from men and young people, highlight the importance of sexually transmitted infection prevention in the United States.
衣原体感染和淋病是美国报告的最常见性传播感染疾病。衣原体感染和淋病感染的检测可按解剖部位（特定部位）进行。监测按解剖部位划分的检测量和阳性率很重要。
利用一个大型的全国实验室数据集，我们评估了15至60岁患者按解剖部位划分的衣原体和淋病检测量及阳性率。
该数据包含2019年至2023年期间衣原体和淋病各4500万次检测。在衣原体检测中，71.6%是针对女性的。在女性中，0.4%、1.5%和98.1%的检测分别针对直肠、咽部和泌尿生殖系统标本；衣原体阳性率分别为7.3%、2.0%和4.3%。在男性中，10.5%、13.7%和75.8%的检测分别针对直肠、咽部和泌尿生殖系统标本；衣原体阳性率分别为8.0%、1.4%和6.3%。在15至24岁人群中，女性直肠衣原体阳性率为12.8%，咽部为3.4%，泌尿生殖系统为8.7%；男性分别为11.6%、2.4%和12.2%。淋病总体检测量以及按年龄和性别划分的检测量与衣原体相似。女性淋病直肠、咽部和泌尿生殖系统阳性率分别为3.2%、2.4%和1.0%；男性分别为6.8%、5.2%和3.3%；15至24岁女性分别为4.3%、3.0%和1.6%，15至24岁男性分别为10.5%、7.2%和4.6%。
尽管男性在衣原体和淋病总体检测中占比不到30%，但他们在生殖器外检测中占多数。许多人口群体中按标本类型划分的衣原体和淋病高阳性率，尤其是男性和年轻人的生殖器外标本，凸显了美国性传播感染预防的重要性。
