{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:00:33Z","timestamp":1790805633115,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T00:00:00Z","timestamp":1560470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>International guidelines recommend the systematic screening for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections in all men who have sex with men (MSM) who have engaged in unprotected sex. However, the optimal screening strategy remains unclear. We developed a modeling approach to optimize NG\/CT screening strategy in MSM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A compartmental model of NG\/CT screening and infection was implemented. NG\/CT anal, pharyngeal, and urine (APU) samples from MSM attending the sexually transmitted infections clinic were used to estimate the screening rate, prevalence, and incidence in a base case scenario. Different screening strategies (scenarios; S) were then evaluated: APU samples every 12 months (S1); APU samples every 3 months (S2); APU samples every 6 months (S3); anal and pharyngeal (AP) samples every 6 months (S4); and AP samples every 3 months (S5).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We analyzed 2973 triplet APU samples from 1255 patients. We observed 485 NG and 379 CT diagnoses. NG\/CT prevalence and incidence estimates were 12.0\/11.1% and 40\/29 per 100 person-years, respectively, in the base case scenario. As compared to S2, the reference strategy, the proportions of missed NG\/CT diagnoses were 42.0\/41.2% with S1, 21.8\/22.5% with S3, 25.6\/28.3% with S4, and 6.3\/10.5% with S5, respectively. As compared to S2, S1 reduced the cost of the analysis by 74%, S3 by 50%, S4 by 66%, and S5 by 33%. The numbers needed to screen for catching up the missed NG\/CT diagnoses were 49\/67 with S1, 62\/82 with S3, 71\/87 with S4, and 143\/118 with S5.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>S5 appears to be the best strategy, missing only 6.3\/10.5% of NG\/CT diagnoses, for a cost reduction of 33%.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz510","type":"journal-article","created":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T11:10:38Z","timestamp":1560424238000},"page":"1966-1972","source":"Crossref","is-referenced-by-count":16,"title":["Optimizing Strategies for Chlamydia trachomatis and Neisseria gonorrhoeae Screening in Men Who Have Sex With Men: A Modeling Study"],"prefix":"10.1093","volume":"70","author":[{"given":"Nicolas","family":"Voirin","sequence":"first","affiliation":[{"name":"EPIdemiology and MODelling of Infectious Diseases, Dompierre sur Veyle, Villeurbanne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Allam","sequence":"first","affiliation":[{"name":"Bacteriology Laboratory, Hospices Civils de Lyon, Villeurbanne"},{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon1, Villeurbanne"},{"name":"Centre International de Recherche en Infectiologie, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Unit\u00e9 1111, Centre National de la Recherche Scientifique, Unit\u00e9 Mixte de Recherche, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Charre","sequence":"first","affiliation":[{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon1, Villeurbanne"},{"name":"Centre International de Recherche en Infectiologie, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Unit\u00e9 1111, Centre National de la Recherche Scientifique, Unit\u00e9 Mixte de Recherche, Lyon, France"},{"name":"Virology Laboratory, Hospices Civils de Lyon, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Fernandez","sequence":"first","affiliation":[{"name":"Centres Gratuits d'Information, de D\u00e9pistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Godinot","sequence":"first","affiliation":[{"name":"Centres Gratuits d'Information, de D\u00e9pistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Oria","sequence":"first","affiliation":[{"name":"Centres Gratuits d'Information, de D\u00e9pistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aymeric","family":"Pansu","sequence":"first","affiliation":[{"name":"Centres Gratuits d'Information, de D\u00e9pistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Chidiac","sequence":"first","affiliation":[{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon1, Villeurbanne"},{"name":"Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Salord","sequence":"first","affiliation":[{"name":"Bacteriology Laboratory, Hospices Civils de Lyon, Villeurbanne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Cotte","sequence":"first","affiliation":[{"name":"Centres Gratuits d'Information, de D\u00e9pistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France"},{"name":"Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,6,14]]},"reference":[{"key":"2020041501053736800_CIT0001","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/QAI.0b013e3181c3ef29","article-title":"Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion","volume":"53","author":"Bernstein","year":"2010","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020041501053736800_CIT0002","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/00007435-200110000-00005","article-title":"A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known?","volume":"28","author":"R\u00f8ttingen","year":"2001","journal-title":"Sex Transm Dis"},{"key":"2020041501053736800_CIT0003","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/cid\/ciy182","article-title":"Effects of pre-exposure prophylaxis for the prevention of human immunodeficiency virus infection on sexual risk behavior in men who have sex with men: a systematic review and meta-analysis","volume":"67","author":"Traeger","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2020041501053736800_CIT0004","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1093\/cid\/cix439","article-title":"Incidence of gonorrhea and chlamydia following human immunodeficiency virus preexposure prophylaxis among men who have sex with men: a modeling study","volume":"65","author":"Jenness","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2020041501053736800_CIT0005","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1089\/apc.2008.0277","article-title":"The prevalence of rectal, urethral, and pharyngeal Neisseria gonorrheae and Chlamydia trachomatis among asymptomatic men who have sex with men in a prospective cohort in Washington, D.C","volume":"23","author":"Baker","year":"2009","journal-title":"AIDS Patient Care STDS"},{"key":"2020041501053736800_CIT0006","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1086\/430704","article-title":"Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003","volume":"41","author":"Kent","year":"2005","journal-title":"Clin Infect Dis"},{"key":"2020041501053736800_CIT0007","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1089\/apc.2007.0240","article-title":"Asymptomatic sexually transmitted infections in HIV-infected men who have sex with men: prevalence, incidence, predictors, and screening strategies","volume":"22","author":"Rieg","year":"2008","journal-title":"AIDS Patient Care STDS"},{"key":"2020041501053736800_CIT0008","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1136\/sextrans-2011-050270","article-title":"Incidence and risk factors associated with chlamydia in men who have sex with men: a cohort analysis of Victorian Primary Care Network for Sentinel Surveillance data","volume":"88","author":"Wilkinson","year":"2012","journal-title":"Sex Transm Infect"},{"key":"2020041501053736800_CIT0009","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1071\/SH15175","article-title":"Duration of gonorrhoea and chlamydia infection at the pharynx and rectum among men who have sex with men: a systematic review","volume":"13","author":"Chow","year":"2016","journal-title":"Sex Health"},{"key":"2020041501053736800_CIT0010","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/OLQ.0000000000000807","article-title":"Spontaneous clearance of pharyngeal gonococcal infections: a retrospective study in patients of the sexually transmitted infections clinic; Amsterdam, the Netherlands; 2012 to 2015","volume":"45","author":"Hananta","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2020041501053736800_CIT0011","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1093\/cid\/ciy029","article-title":"Characteristics of cases with repeated sexually transmitted infections, Massachusetts, 2014\u20132016","volume":"67","author":"Hsu","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2020041501053736800_CIT0012","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1097\/OLQ.0000000000000616","article-title":"Biological and behavioral factors associated with positive chlamydia retests","volume":"44","author":"Smith","year":"2017","journal-title":"Sex Transm Dis"},{"key":"2020041501053736800_CIT0013","volume-title":"Sexually transmitted diseases treatment guidelines","author":"Centers for Disease Control and Prevention"},{"key":"2020041501053736800_CIT0014","volume-title":"Australian sexually transmitted infection & HIV testing guidelines 2014","author":"Sexually Transmitted Infections in Gay Men Action Group (STIGMA)"},{"key":"2020041501053736800_CIT0015","first-page":"956462417746897","article-title":"2016 United Kingdom national guideline on the sexual health care of men who have sex with men","author":"Clutterbuck","year":"2018","journal-title":"Int J STD AIDS"},{"key":"2020041501053736800_CIT0016","volume-title":"Recommandations diagnostiques et th\u00e9rapeutiques pour les Maladies Sexuellement Transmissibles","author":"Soci\u00e9t\u00e9 Fran\u00e7aise de Dermatologie"},{"key":"2020041501053736800_CIT0017","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/OLQ.0000000000000435","article-title":"Extragenital screening in men who have sex with men diagnoses more chlamydia and gonorrhea cases than urine testing alone","volume":"43","author":"Anschuetz","year":"2016","journal-title":"Sex Transm Dis"},{"key":"2020041501053736800_CIT0018","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/OLQ.0000000000000384","article-title":"Patterns of extragenital chlamydia and gonorrhea in women and men who have sex with men reporting a history of receptive anal intercourse","volume":"43","author":"Danby","year":"2016","journal-title":"Sex Transm Dis"},{"key":"2020041501053736800_CIT0019","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1097\/OLQ.0b013e31822a2b2e","article-title":"Infections missed by urethral-only screening for chlamydia or gonorrhea detection among men who have sex with men","volume":"38","author":"Marcus","year":"2011","journal-title":"Sex Transm Dis"},{"key":"2020041501053736800_CIT0020","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1258\/ijsa.2012.011378","article-title":"The value of testing multiple anatomic sites for gonorrhoea and chlamydia in sexually transmitted infection centres in the Netherlands, 2006\u20132010","volume":"23","author":"Koedijk","year":"2012","journal-title":"Int J STD AIDS"},{"key":"2020041501053736800_CIT0021","article-title":"Quarterly screening optimizes STI detection among PrEP users in the demo project","author":"Cohen"},{"key":"2020041501053736800_CIT0022","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1097\/EDE.0000000000000655","article-title":"Estimating local chlamydia incidence and prevalence using surveillance data","volume":"28","author":"Lewis","year":"2017","journal-title":"Epidemiology"},{"key":"2020041501053736800_CIT0023","doi-asserted-by":"crossref","first-page":"3236","DOI":"10.1128\/JCM.01019-10","article-title":"Performance of the Abbott RealTime CT\/NG for detection of Chlamydia trachomatis and Neisseria gonorrhoeae","volume":"48","author":"Gaydos","year":"2010","journal-title":"J Clin Microbiol"},{"key":"2020041501053736800_CIT0024","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.diagmicrobio.2013.06.020","article-title":"Performance of cobas\u00ae 4800 and m2000 real-time\u2122 assays for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in rectal and self-collected vaginal specimen","volume":"77","author":"Geelen","year":"2013","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2020041501053736800_CIT0025","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s10096-010-1120-y","article-title":"Molecular detection and confirmation of Neisseria gonorrhoeae in urogenital and extragenital specimens using the Abbott CT\/NG RealTime assay and an in-house assay targeting the porA pseudogene","volume":"30","author":"Walsh","year":"2011","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2020041501053736800_CIT0026","doi-asserted-by":"crossref","first-page":"S669","DOI":"10.1093\/ofid\/ofx163.1786","article-title":"High rate of asymptomatic bacterial sexually transmitted infections (STIs) in men who have sex with men on pre exposure prophylaxis (PrEP)","volume":"4","author":"La Fata","year":"2017","journal-title":"Open Forum Infect Dis"},{"key":"2020041501053736800_CIT0027","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-642-28070-2","volume-title":"Solving differential equations in R","author":"Soetaert","year":"2012"},{"key":"2020041501053736800_CIT0028","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v033.i03","article-title":"Inverse modelling, sensitivity and Monte Carlo analysis in R using package FME","volume":"33","author":"Soetaert","year":"2010","journal-title":"J Stat Softw"},{"key":"2020041501053736800_CIT0029","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.cmi.2017.02.020","article-title":"Asymptomatic and symptomatic urethral gonorrhoea in men who have sex with men attending a sexual health service","volume":"23","author":"Ong","year":"2017","journal-title":"Clin Microbiol Infect"},{"key":"2020041501053736800_CIT0030","doi-asserted-by":"crossref","first-page":"2971","DOI":"10.1128\/JCM.00899-14","article-title":"Characteristics of acute nongonococcal urethritis in men differ by sexual preference","volume":"52","author":"Rane","year":"2014","journal-title":"J Clin Microbiol"},{"key":"2020041501053736800_CIT0031","first-page":"110","article-title":"Persistent increase in the incidence of acute male urethritis diagnosed in general practices in France","volume":"56","author":"Massari","year":"2006","journal-title":"Br J Gen Pract"},{"key":"2020041501053736800_CIT0032","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1097\/OLQ.0b013e31825159ff","article-title":"Describing the progression from Chlamydia trachomatis and Neisseria gonorrhoeae to pelvic inflammatory disease: systematic review of mathematical modeling studies","volume":"39","author":"Herzog","year":"2012","journal-title":"Sex Transm Dis"},{"key":"2020041501053736800_CIT0033","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.epidem.2010.04.002","article-title":"Transmission dynamics of Chlamydia trachomatis affect the impact of screening programmes","volume":"2","author":"Althaus","year":"2010","journal-title":"Epidemics"},{"key":"2020041501053736800_CIT0034","doi-asserted-by":"crossref","first-page":"e271","DOI":"10.1016\/S2468-2667(18)30071-9","article-title":"Changes in chlamydia prevalence and duration of infection estimated from testing and diagnosis rates in England: a model-based analysis using surveillance data, 2000-15","volume":"3","author":"Lewis","year":"2018","journal-title":"Lancet Public Health"},{"key":"2020041501053736800_CIT0035","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1128\/JCM.02460-15","article-title":"The \u201c3 in 1\u201d study: pooling self-taken pharyngeal, urethral, and rectal samples into a single sample for analysis for detection of Neisseria gonorrhoeae and Chlamydia trachomatis in men who have sex with men","volume":"54","author":"Sultan","year":"2016","journal-title":"J Clin Microbiol"},{"key":"2020041501053736800_CIT0036","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/OLQ.0000000000000722","article-title":"Screening for Chlamydia trachomatis and Neisseria gonorrhoeae infections in men who have sex with men: diagnostic accuracy of nucleic acid amplification test on pooled urine, anorectal, and pharyngeal specimens","volume":"45","author":"Thielemans","year":"2018","journal-title":"Sex Transm Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciz510\/29095092\/ciz510.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/70\/9\/1966\/33045535\/ciz510.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/70\/9\/1966\/33045535\/ciz510.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T05:06:06Z","timestamp":1586927166000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/70\/9\/1966\/5519038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,14]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,6,14]]},"published-print":{"date-parts":[[2020,4,15]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciz510","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,5,1]]},"published":{"date-parts":[[2019,6,14]]}}}