The prevalence of Chlamydia trachomatis among 3,026 asymptomatic males tested on urine with the ligase chain reaction (LCR) was 5.9%. Only 13.7%, 5.6%, and 1.5% of men reported having, respectively, two or more sex partners, a new sex partner, or an STD contact in the last 60 days. Age was an important predictor of infection. Compared to universal testing, screening all men less than 30 years of age and only older men with risk factors identified 90.4% of infections while testing 56.9% of males. Adopting this screening strategy will result in significant savings while identifying the majority of infections.
Get full access to this article
View all access options for this article.
References
1.
Centers for Disease Control and Prevention. (2001). Sexually transmitted disease surveillance 2000. Atlanta, GA: Author.
2.
Centers for Disease Control and Prevention. (2002). Sexually transmitted disease treatment guidelines 2002. MMWR, 51(No. RR-6), 1-80.
3.
CieminsE., FloodJ., KentC., ShawH., RowniakS., MoncadaJ., et al. (2000). Reexamining the prevalence of Chlamydia trachomatis infection among gay men with urethritis—Implications for STD policy and HIV prevention activities. Sexually Transmitted Disease, 27, 249-251.
4.
Dicker, L. W., Mosure, D. J., & Levine, W. C. (1998). Chlamydia positivity versus prevalence: What’s the difference?. Sexually Transmitted Disease, 25, 251-253.
5.
Fenton, K. A. (2000). Screening for Chlamydia trachomatis infection: Have we fully explored the possibilities?. Communicable Disease and Public Health, 3, 2-3.
6.
Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: The contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infection, 75, 3-17.
7.
HamelM., JudsonF., & RietmeijerC. (2001). Screening for Chlamydia trachomatis in an anonymous and confidential HIV counseling and testing site: Feasibility and prevalence rates. Sexually Transmitted Disease, 28, 153-157.
8.
Kelly, P. J., Bair, R. M., BaillargeonJ., & GermanV. (2000). Risk behaviors and the prevalence of Chlamydia in a juvenile detention facility. Clinical Pediatrics, 39, 521-527.
9.
LatkaM., AhernJ., Garfein, R. S., OuelletL., KerndtP., MorseP., et al. (2001). Collaborative injection drug user study group prevalence, incidence, and correlates of chlamydia and gonorrhea among young adult injection drug users. Journal of Substance Abuse, 13(1-2), 73-88.
10.
Lee, H. H., Chernesky, M. A., SchachterJ., Burczak, J. D., Andrews, W. W., MuldoonS., et al. (1995). Diagnosis of Chlamydia trachomatis genitourinary infection in women by ligase chain reaction assay of urine. Lancet, 345, 213-216.
11.
Lifson, A. R., Halcon, L. L., HannanP., St. Louis, M. E., & Hayman, C. R. (2001, March). Screening for sexually transmitted infections among economically disadvantaged youth in a national job training program. Journal of Adolescent Health, 28(3), 190-196.
12.
MarrazzoJ., Whittington, A. B., CelumC., HandsfieldH., ClarkA., ClesL., et al. (2001). Urine-based screening for Chlamydia trachomatis in men attending sexually transmitted disease clinics. Sexually Transmitted Disease, 28, 219-225.
13.
Massachusetts Department of Public Health, Division of STD Prevention. (2000). [Infertility project]. Unpublished raw data.
14.
Mertz, K. J., Schwebke, J. R., Gaydos, C. A., Beideinger, H. A., Tulloch, S. D., & Levine, W. C. (2002). Screening women in jails for chlamydial and gonococcal infection using urine tests: Feasibility, acceptability, prevalence, and treatment rates. Sexually Transmitted Disease, 29, 271-276.
15.
Michaelson, K. N., Thomas, J. C., BoydC., & Janssens, A. H. (1999). Chlamydia trachomatis infection in a rural population: The importance of screening men. International Journal of STD & AIDS, 10, 35-38.
16.
Morre, S. A., WelteR., & Postma, M. J. (2002). Major improvements in cost effectiveness of screening women for Chlamydia trachomatis using pooled urine specimens and high performance testing. Sexually Transmitted Infection, 78(1), 74-75.
17.
NeuN., GrumetS., McNeesA., LaiL., Della-LattaP., WhittierS., et al. (1999). Screening for Chlamydia trachomatis in young men by ligase chain reaction. Pediatric Infectious Disease Journal, 18, 649-650.
18.
Oh, M. K., Smith, K. R., O’CainM., KilmerD., JohnsonJ., & Hook III, E. W. (1998). Urine-based screening of adolescents in detention to guide treatment for gonococcal and chlamydial infections. Translating research into interventions. Archives of Pediatrics and Adolescent Medicine, 152, 52-56.
19.
PackR., DiclementeR., HookE., & OhM. (2000). High prevalence of asymptomatic STDs in incarcerated minority male youth: A case for screening. Sexually Transmitted Disease, 27, 176-179.
20.
Peeling, R. W., ToyeB., JessamineP., & GemmillI. (1998). Pooling of urine specimens for PCR testing: A cost saving strategy for Chlamydia trachomatis control programmes. Sexually Transmitted Infections, 74(1), 66-70.
21.
RatelleS., Nguyen, M. S., TangY., WhelanM., EtkindP., LincolnT., et al. (2003). Low sensitivity of the leukocyte esterase test (LET) in detecting Chlamydia trachomatis infections in asymptomatic men entering a county jail. Journal of Correctional Health Care, 10, 217-226.
22.
Shafer, M. A., Boyer, C. B., Shaffer, R. A., SchachterJ., Ito, S. I., & Brodine, S. K. (2002). Correlates of sexually transmitted diseases in a young male deployed military population. Military Medicine, 167, 496-500.
23.
Todd, C. S., HaaseC., & Stoner, B. P. (2001). Emergency department screening for asymptomatic sexually transmitted infections. American Journal of Public Health, 91, 461-464.
24.
U.S. Preventive Services Task Force. (2001). Guide to clinical preventive services, 3rd edition: Periodic updates. Retrieved from http://www.ahrq.gov/clinic/gcpspu.htm
