{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:34:19Z","timestamp":1777962859687,"version":"3.51.4"},"reference-count":30,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Pharyngeal and rectal<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) and<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(NG) infections are often undiagnosed due to their asymptomatic nature. This study aims to determine (1) the prevalence of CT\/NG infections by anatomical site among cisgender men; (2) the proportion of missed CT\/NG rectal\/pharyngeal infections if urogenital testing alone was performed or screening depended on self-reported behaviour alone; and (3) the predictive probability of self-reported behaviours for rectal CT\/NG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study used electronic health records collected at a sexual health clinic in Los Angeles from 18 November 2018 until 28 February 2020. The included patients were \u226518 years of age cisgender men who received CT\/NG testing at least once during the study period. We calculated the proportion of missed pharyngeal\/rectal CT\/NG infections if only urogenital testing had been done and if testing was based only on self-reported anal sex. Separately, we ran logistic regressions for predictive probability of self-reported anal sex on CT\/NG rectal infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, there were 13\u2009476 unique patients with 26\u2009579 visits. The prevalence of any extragenital CT\/NG infection was 37.28%. Over 80% rectal\/pharyngeal CT cases and over 65% rectal\/pharyngeal NG cases would be missed if urogenital testing alone was performed. Likewise, over 35% rectal CT\/NG cases would be missed had testing relied on self-reported sexual behaviours alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The proportion of missed rectal and pharyngeal CT\/NG infections is high. Our data from a sexual health clinic lend support to three-site opt-out testing for cisgender men attending a sexual health\/Lesbian, Gay, Bisexual, Transgender, Queer\/Questioning (LGBTQ+) specialty clinic regardless of their sexual orientation or reported sexual behaviours.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2021-055361","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T18:20:59Z","timestamp":1645813259000},"page":"586-591","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["High proportions of rectal and pharyngeal chlamydia and gonorrhoea cases among cisgender men are missed using current CDC screening recommendations"],"prefix":"10.1136","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6651-1765","authenticated-orcid":false,"given":"Ryan D","family":"Assaf","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7695-5036","authenticated-orcid":false,"given":"Nicole J","family":"Cunningham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2776-6458","authenticated-orcid":false,"given":"Paul C","family":"Adamson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3230-0908","authenticated-orcid":false,"given":"Jamieson Trevor","family":"Jann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert K","family":"Bolan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"2023100200001843000_98.8.586.1","unstructured":"Centers for Disease Control and Prevention . 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