Should we still treat asymptomatic <i>Neisseria gonorrhoeae</i> and <i>Chlamydia trachomatis</i> contacts in the era of NAATs? Reviewing data from the GetaKit study to inform practice
Bibliographic record
Abstract
OBJECTIVES: (CT). Our goal was to shed light on current discrepancies between international sexually transmitted infection (STI) guidelines, some of which recommend blanket empiric treatment for all NG and CT contacts (eg, Canadian and United States guidelines) versus others which recommend waiting for positive results (BASHH, Australian, and European). METHODS: We extracted data for the period of 1 June 2023 to 30 June 2025 from GetaKit, which is a research website through which persons in Ontario, Canada can complete an online risk assessment and obtain access to laboratory-based testing for STIs, including NG, CT, HIV, syphilis and hepatitis C. From these data, we calculated positivity rates for NG and CT and the numbers needed to treat. We also evaluated for correlations of risk factors for testing positive. RESULTS: During our 25-month study period, participants ordered NG/CT testing 12 775 times. In a total of 6.7% of these orders, participants identified as an NG and/or CT contact. Positivity rates, for all completed testing, were 1.2% (n=115 diagnoses) for NG and 4.3% (n=395 diagnoses) for CT. Positivity among asymptomatic contacts ranged from 0% for NG in heterosexual males to 30.6% for CT in females who were ≤24 years old, with most positivity rates being <20% for both infections. CONCLUSIONS: Our results suggest that blanket recommendations to treat or defer treatment seems inappropriate. More nuance is required. Empiric treatment of all NG and CT contacts will likely result in mass overuse of antibiotics. In contrast, deferring treatment seems inappropriate for asymptomatic females who are ≤24 years old and for anyone who cannot immediately obtain testing and treatment.
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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 | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".