{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:53:16Z","timestamp":1788263596291,"version":"build-2803163510"},"reference-count":15,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["HHSH250201600009C"],"award-info":[{"award-number":["HHSH250201600009C"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["HHSA290201100007C"],"award-info":[{"award-number":["HHSA290201100007C"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI084854"],"award-info":[{"award-number":["K23AI084854"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI125715"],"award-info":[{"award-number":["K23AI125715"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["P30 AI036214"],"award-info":[{"award-number":["P30 AI036214"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U01 DA036935, P30 AI094189"],"award-info":[{"award-number":["U01 DA036935, P30 AI094189"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,3,3]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Current guidelines recommend screening sexually active persons with HIV (PWH) for<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(NG) and<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) at least annually. Yet, screening rates in many HIV clinics remain low. In this study, we estimated the number needed to screen (NNS) to detect a NG and\/or CT infection at each anatomic site among different subpopulations of PWH. NNS provides a concrete, practical measure to aid in assessing the practical impact of screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods\u00a0<\/jats:title><jats:p>We included adults in care at three HIV Research Network sites in 2011\u20132014. Restricting to first tests within each year, annual NNS was defined as number of persons tested divided by number positive. We computed urogenital and extragenital NNS by age and risk group (women, men who have sex with women (MSW) and men who have sex with men (MSM)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results\u00a0<\/jats:title><jats:p>A total of 16\u2009864 NG\/CT tests were included. Among patients aged \u226425 years, urogenital NNS was similar among women (15 (95% CI 6 to 71)), MSW (21 (95% CI 6 to 167)) and MSM (20 (95% CI 12 to 36)). Over 25, urogenital NNS increased to a greater extent for women (363 (95% CI 167 to 1000)) and MSW (160 (95% CI 100 to 333)) than MSM (46 (95% CI 38 to 56)). The increase for women versus MSM &gt;25 remained significant (p&lt;0.01) in multivariable analysis. Among MSM, rectal NNS was 5 (95% CI 3 to 7) and 10 (95% CI 9 to 12) for \u226425\u2009and for &gt;25 years and pharyngeal NNS values were 8 (95% CI 5 to 13) and 20 (95% CI 16 to 24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings suggest the importance of regular, at least annual NG\/CT screening, particularly extragenital, of HIV positive MSM of all ages. They provide some support for age-based cutoffs for women and MSW (eg, universal screening for those aged \u226425\u2009and targeted screening for those aged &gt;25 years).<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2018-053793","type":"journal-article","created":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T21:15:25Z","timestamp":1554585325000},"page":"322-327","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Gonorrhoea and chlamydia in persons with HIV: number needed to screen"],"prefix":"10.1136","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5910-956X","authenticated-orcid":false,"given":"Susan","family":"Tuddenham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil G","family":"Ghanem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly A","family":"Gebo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William Christopher","family":"Mathews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Agwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Schumacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Raifman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A","family":"Berry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,6]]},"reference":[{"key":"2024092304402302000_95.5.322.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6404a1"},{"key":"2024092304402302000_95.5.322.2","doi-asserted-by":"crossref","unstructured":"Tong C , Heudebert JP , Tamhane AR . Gonorrheaand chlamydia testing in routine clinical care of HIV-positive MenWho have sex with men. Philadelphia: IDWeek, 2014.","DOI":"10.1093\/ofid\/ofu052.1130"},{"key":"2024092304402302000_95.5.322.3","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31822e6136"},{"key":"2024092304402302000_95.5.322.4","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181e50058"},{"key":"2024092304402302000_95.5.322.5","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2011-050051"},{"key":"2024092304402302000_95.5.322.6","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.041541"},{"key":"2024092304402302000_95.5.322.7","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/OLQ.0000000000000695","article-title":"Sexually transmitted infection testing of HIV-positive Medicare and Medicaid enrollees falls short of guidelines","volume":"45","author":"Landovitz","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2024092304402302000_95.5.322.8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/OLQ.0000000000000691","article-title":"Prevalence of gonorrhea and Chlamydia testing by anatomical site among men who have sex with men in HIV medical care, United States, 2013-2014","volume":"45","author":"Patel","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2024092304402302000_95.5.322.9","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/QAI.0000000000001514","article-title":"Gonorrhea and Chlamydia case detection increased when testing increased in a multisite us HIV Cohort, 2004-2014","volume":"76","author":"Raifman","year":"2017","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024092304402302000_95.5.322.10","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2008.0093"},{"key":"2024092304402302000_95.5.322.11","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit757"},{"key":"2024092304402302000_95.5.322.12","unstructured":"Centers for Disease Control Sexually Transmitted Diseases Surveillance , 2017. Available: https:\/\/www.cdc.gov\/std\/stats17\/default.htm"},{"key":"2024092304402302000_95.5.322.13","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050889"},{"key":"2024092304402302000_95.5.322.14","doi-asserted-by":"crossref","unstructured":"Asavapiriyanont S , Lolekha R , Roongpisuthipong A , et al . Sexually transmitted infections among HIV-infected women in Thailand. 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