{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:09:21Z","timestamp":1782968961408,"version":"3.54.5"},"reference-count":22,"publisher":"BMJ","issue":"7","funder":[{"name":"LINKAGES","award":["AID-OAA-A-14-00045"],"award-info":[{"award-number":["AID-OAA-A-14-00045"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,4,2]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Comprehensive data on<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) and<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(NG) infections to guide screening services among transgender women (TGW) are limited. We studied the burden of CT\/NG infections in pharyngeal, rectal and urethral sites of Thai TGW and determined missed CT\/NG diagnoses if selected site screening was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thai TGW were enrolled to the community-led test and treat cohort. CT\/NG screening was performed from pharyngeal swab, rectal swab and urine using nucleic acid amplification test. CT\/NG prevalence in each anatomical site was analysed, along with the relationships of CT\/NG among the three anatomical sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 764 TGW included in the analysis, 232 (30.4%) had CT\/NG infections at any anatomical site, with an overall incidence of 23.7 per 100 person-years. The most common CT\/NG infections by anatomical site were rectal CT (19.5%), rectal NG (9.6%) and pharyngeal NG (8.1%). Among 232 TGW with CT\/NG infections at any anatomical site, 22%\u201394.4% of infections would have been missed if single anatomical site testing was conducted, depending on the selected site. Among 668 TGW who tested negative at pharyngeal site, 20.4% had either rectal or urethral infections. Among 583 TGW who tested negative at the rectal site, 8.7% had either pharyngeal or urethral infections. Among 751 TGW who tested negative at the urethral site, 19.2% had either pharyngeal or rectal infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Almost one-third of Thai TGW had CT\/NG infections. All-site screening is highly recommended to identify these infections, but if not feasible rectal screening provides the highest yield of CT\/NG diagnoses. Affordable molecular technologies and\/or CT\/NG screening in pooled samples from different anatomical sites are urgently needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03580512\">NCT03580512<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2018-053835","type":"journal-article","created":{"date-parts":[[2019,4,13]],"date-time":"2019-04-13T21:16:36Z","timestamp":1555190196000},"page":"534-539","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["High burden of chlamydia and gonorrhoea in pharyngeal, rectal and urethral sites among Thai transgender women: implications for anatomical site selection for the screening of STI"],"prefix":"10.1136","volume":"95","clinical-trial-number":[{"clinical-trial-number":"nct03580512","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1906-8171","authenticated-orcid":false,"given":"Akarin","family":"Hiransuthikul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rena","family":"Janamnuaysook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanthip","family":"Sungsing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jureeporn","family":"Jantarapakde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deondara","family":"Trachunthong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Mills","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravipa","family":"Vannakit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praphan","family":"Phanuphak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nittaya","family":"Phanuphak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,13]]},"reference":[{"key":"2024092304402116000_95.7.534.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70315-8"},{"key":"2024092304402116000_95.7.534.2","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1071\/SH17096","article-title":"Current research gaps: a global systematic review of HIV and sexually transmissible infections among transgender populations","volume":"14","author":"MacCarthy","year":"2017","journal-title":"Sex Health"},{"key":"2024092304402116000_95.7.534.3","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1071\/SH17050","article-title":"Transgender HIV and sexually transmissible infections","volume":"14","author":"McNulty","year":"2017","journal-title":"Sex Health"},{"key":"2024092304402116000_95.7.534.4","unstructured":"WHO Guidelines Approved by the Guidelines Review Committee . Who guidelines for the treatment of Neisseria gonorrhoeae. Geneva World Health Organization; 2016."},{"key":"2024092304402116000_95.7.534.5","unstructured":"WHO Guidelines Approved by the Guidelines Review Committee . Who guidelines for the treatment of Chlamydia trachomatis. Geneva World Health Organization; 2016."},{"key":"2024092304402116000_95.7.534.6","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/OLQ.0000000000000614","article-title":"New human immunodeficiency virus diagnosis independently associated with rectal gonorrhea and Chlamydia in men who have sex with men","volume":"44","author":"Barbee","year":"2017","journal-title":"Sex Transm Dis"},{"key":"2024092304402116000_95.7.534.7","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181c3ef29"},{"key":"2024092304402116000_95.7.534.8","doi-asserted-by":"crossref","unstructured":"Chhim S , Ngin C , Chhoun P , et al . 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