1584Gonorrhea and Chlamydia Testing in Routine Clinical Care of HIV-Infected Men Who Have Sex with Men
Bibliographic record
Abstract
Background. Men who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmitted diseases (STDs) including Neisseria gonorrhoeae (GC) and Chlamydia trachomatis(CT). Centers for Disease Control and Prevention STD Treatment Guidelines recommend screening sexually active MSM annually for urogenital and extragenital GC/CT, depending upon sites of exposure. Data on rates, correlates, and results of GC/CT testing among HIV+ MSM in routine HIV clinical care are limited. Methods. A cross-sectional study at a university-based HIV clinic evaluated GC/CT testing among established patients in 2012, with primary focus on MSM. Patients were included if ≥19 years old, in care for >1 year, with at least 2 visits ≥90 days apart within the last year. Results. Of 1,523 eligible patients (mean age 46 years; 59% MSM, 18% heterosexual men, 23% women; 53% African-American), 632 (41%) received GC/CT testing within the prior year. Testing was more prevalent among women than heterosexual men or MSM (67% vs 32% vs 35%). Among MSM (n = 890), 307 received GC/CT testing of which urogenital GC/CT testing was done in 32%, rectal in 9% and pharyngeal in 3%. Overall 15 patients tested positive for GC and 16 for CT; most were MSM (14/15 and 13/16 respectively). Among MSM receiving rectal testing (n = 77), 12% were GC and 16% CT positive. Of 9 positive rectal tests for GC in MSM, urogenital testing was also done in 6 [positive = 1]. Of 12 positive rectal tests for CT in MSM, urogenital testing was also done in 9 [positive = 2]. In multivariable analysis, factors significantly associated with increased GC/CT testing among MSM included African-American race (prevalence ratio, PR 1.30; 95% CI: 1.08-1.55) and self-reported sex without condom use (PR1.36; 95% CI: 1.07-1.73), while age (PR 0.93 per 5 year increase; 95% CI 0.89-0.97) and STD history (PR 0.81; 95% CI 0.69-0.97) were significantly associated with decreased testing. Conclusion. Prevalence of GC/CT testing among MSM in routine HIV care was low, particularly extragenital testing. Most positive GC/CT results were from rectal testing in MSM, and corresponding urogenital tests were usually negative. Increased rectal GC/CT testing among HIV+ MSM would likely capture a significant number of undiagnosed GC and CT infections. Disclosures. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".