Sentinel Surveillance for Rectal Chlamydia and Gonorrhea in San Francisco

1. Sentinel Surveillance for Rectal Chlamydia and Gonorrhea in San Francisco Kyle T. Bernstein1, Sally C. Stephens1,2, Julia L. Marcus1, Ameera Snell1, Leah Rauch1, Sally Liska1, Susan S. Philip1, Jeffrey D. Klausner1 1San Francisco Department of Public Health; 2CDC/CSTE Applied Epidemiology Fellowship Background Results • Rectal Chlamydia trachomatis (CT) and Neisseria gonorrheae (GC) infections are both markers of high risk sexual behavior and risk factors for HIV infection. • The San Francisco Department of Public Health recommends that men who have sex with men (MSM) be screened every three to six months for these rectal infections. • Because most rectal infections are asymptomatic, trends in reported numbers of rectal infections are difficult to interpret because increased screening often translates into increased case finding. Rectal chlamydia and gonorrhea tests and positivity among males at sentinel surveillance sites, San Francisco, 2005-2008 Objective • To examine trends in rectal CT and GC positivity among MSM in San Francisco during 2005-2008 in three types of sentinel surveillance clinics: an STD clinic, a gay men’s health clinic, and two HIV care clinics. Methods • The San Francisco Department of Public Health provides rectal CT and GC testing to MSM at the municipal STD clinic, a gay men’s health clinic, and two HIV care clinics. • All rectal CT/GC testing is conducted by the San Francisco Department of Public Health, Public Health Laboratory using the Gen-Probe APTIMA Combo2®Assay. • Both positive and negative rectal CT and GC results are reported to San Francisco Department of Public Health, STD Prevention and Control Services for these four clinics. • Trends in positivity among MSM at the three clinic types were examined during 2005-2008 using two-sided Cochran-Armitage tests for trend. Conclusions • Average rectal CT and GC positivity was 8.2% and 7.0%, respectively. • During 2005-2008, while testing volume increased, rectal CT positivity was stable across all three clinic types. • Rectal GC positivity declined at the STD clinic (p<0.001), but remained stable at the gay men’s health clinic and two HIV care clinics. • Sentinel surveillance of rectal infections is critical in monitoring local disease trends. STD Prevention and Control Services, SF Department of Public Health. 1360 Mission Street, Suite 401, San Francisco, CA 94103. Phone (415) 355-2000. Fax (415) 554-9636. Email: kyle.bernstein@sfdph.org Website: www.sfcityclinic.org ISSTDR 2009 STD Prevention and Control Services, SF Department of Public Health, 1360 Mission Street , Suite 401, San Francisco, CA 94103. Phone (415) 355-2000. Fax (415) 554-9636. Website: www.sfcityclinic.org ISSTDR 2005