{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T11:55:18Z","timestamp":1758369318632,"version":"3.44.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","funder":[{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.","award":["W81XWH-18-2-0040"],"award-info":[{"award-number":["W81XWH-18-2-0040"]}]},{"name":"U.S. DoD"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Sexually transmitted infections (STIs) place a high burden on the Military Health System (MHS) and adversely impact service members\u2019 ability to perform their duties. This study examined Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) epidemiology among a population of U.S. service members and their beneficiaries and explored differences in CT and NG prevalence by anatomic site and sex.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted cross-sectional analyses of enrollment visit data from participants in a randomized controlled trial of a behavioral intervention to prevent STIs (Knocking out Infections through Safer sex and Screening) at Joint Base Lewis-McChord, WA and Fort Liberty, NC. At enrollment, participants completed questionnaires and provided biological specimens for nucleic acid amplification testing for CT and NG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 439 participants enrolled between November 2020 and February 2023, 423 (96.4%) were on active duty in the U.S. Army. Of these participants, 173 (39.4%) were female and the median age was 23 (interquartile range 21, 25) years. A reactive test for CT or NG at any anatomic site was observed in 120 participants (prevalence 27.3%), including 60 who had a reactive test for CT or NG at oropharyngeal and\/or anorectal sites (prevalence 13.7%). Anorectal CT prevalence was significantly higher among females than males (12.7% vs. 5.3%; P\u2009=\u2009.005).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study highlights opportunities to improve screening to identify cases of CT and\/or NG that may otherwise go undetected and thus lead to adverse health outcomes, especially for females. The high burden of extragenital CT\/NG also underscores the importance of generating evidence to inform more comprehensive screening, treatment, and prevention strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaf151","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T07:26:35Z","timestamp":1748244395000},"page":"242-251","source":"Crossref","is-referenced-by-count":0,"title":["The Hidden Burden of Extragenital Chlamydial and Gonorrheal Infections in a Population of U.S. Army Service Members and Their Medical Beneficiaries"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8957-9335","authenticated-orcid":false,"given":"Danielle","family":"Bartolanzo","sequence":"first","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research , Silver Spring, MD 20910,","place":["USA"]},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine , Bethesda, MD 20817,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew L","family":"Romo","sequence":"additional","affiliation":[{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine , Bethesda, MD 20817,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-0100","authenticated-orcid":false,"given":"Sarah C","family":"Moreland","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research , Silver Spring, MD 20910,","place":["USA"]},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine , Bethesda, MD 20817,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Dear","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research , Silver Spring, MD 20910,","place":["USA"]},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine , Bethesda, MD 20817,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexus","family":"Reynolds","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research , Silver Spring, MD 20910,","place":["USA"]},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine , Bethesda, MD 20817,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen M","family":"Sevilla","sequence":"additional","affiliation":[{"name":"Department of Public Health, Womack Army Medical Center , Fort Liberty, NC 28310,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John L","family":"MacArthur","sequence":"additional","affiliation":[{"name":"Department of Pathology, Womack Army Medical Center , Fort Liberty, NC 28310,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brennan","family":"Cebula","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research , Silver Spring, MD 20910,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M","family":"Faestel","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center , Joint Base Lewis-McChord, WA 98431,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gina M","family":"Wingood","sequence":"additional","affiliation":[{"name":"Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health , New York, NY 10032,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph J","family":"DiClemente","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, New York University School of Global Public Health , New York, NY 10003,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor A","family":"Crowell","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research , Silver Spring, MD 20910,","place":["USA"]},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine , Bethesda, MD 20817,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A","family":"Ake","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research , Silver Spring, MD 20910,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatjana P","family":"Calvano","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center , Joint Base Lewis-McChord, WA 98431,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjali","family":"Kunz","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center , Joint Base Lewis-McChord, WA 98431,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donn J","family":"Colby","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research , Silver Spring, MD 20910,","place":["USA"]},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine , Bethesda, MD 20817,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"issue":"10","key":"2025092002192464400_R1","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1097\/OLQ.0000000000001973","article-title":"Estimates of the lifetime productivity costs of chlamydia, gonorrhea, and syphilis in the United 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recommendations and the 2021 Centers for Disease Control and Prevention sexually transmitted infection treatment guidelines","volume":"74","author":"Barbee","year":"2022","journal-title":"Clinl Infect Dis"},{"author":"World Health Organization","key":"2025092002192464400_R12","article-title":"Sexually transmitted infections (STIs)"},{"issue":"3","key":"2025092002192464400_R13","first-page":"382","article-title":"Sexually transmitted infection co-testing in a large urban emergency department","volume":"25","author":"Ford","year":"2024","journal-title":"West J Emerg Med"},{"issue":"6","key":"2025092002192464400_R14","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1089\/jwh.2024.0367","article-title":"Clinical updates in sexually transmitted infections, 2024","volume":"33","author":"Hufstetler","year":"2024","journal-title":"J Women\u2019s 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