{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T06:48:13Z","timestamp":1776494893285,"version":"3.51.2"},"reference-count":30,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1R03AI156261-01"],"award-info":[{"award-number":["1R03AI156261-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["TL1 TR002318"],"award-info":[{"award-number":["TL1 TR002318"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2022,12,26]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Epidemiological treatment of persons who are sexual contacts to partners with<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(NG) and<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) often results in treatment of uninfected persons, which may increase the risk of antibiotic-resistant infections. We sought to identify the predictors of NG and\/or CT infections to develop a risk score that could be used to limit epidemiological treatment to persons most likely to have these infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included visits to the Public Health - Seattle &amp; King County Sexual Health Clinic by asymptomatic cisgender men who have sex with men (MSM) aged \u226518 who presented as a sexual contact to partner(s) with CT or NG infection between 2011 and 2019. We used logistic regression to estimate the odds of CT and\/or NG infections associated with demographic and clinical predictors, selecting the final set of predictors using the Akaike information criteria and obtaining score weights from model coefficients. We used a cross-validation approach to obtain average model discrimination from each of 10 models, leaving out 10% of the data, and evaluated sensitivity and specificity at various score cut-offs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final model for predicting NG or CT infection included seven predictors (age &lt;35 years, HIV status, receptive oral sex in the prior 2 months, CT diagnosis, condomless receptive anal intercourse, condomless insertive anal intercourse and methamphetamine use in the prior 12 months). Model discrimination, as measured by the receiver operating curve, was 0.60 (95% CI 0.54 to 0.66). Sensitivity for detection of infection was \u226590% for scores \u22653, \u22655 and \u22657; specificity for these cut-offs was &lt;16%. At scores \u22659, \u226512 and \u226514, specificity increased but sensitivity decreased to \u226476%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our risk score did not sufficiently discriminate between asymptomatic MSM with and without NG\/CT infection. Additional studies evaluating epidemiological treatment as a standard of care in diverse populations are needed to guide best practices in the management of contacts to NG\/CT infection.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2022-055608","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T18:20:37Z","timestamp":1673029237000},"page":"380-385","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Inadequate performance of a risk score to predict asymptomatic<i>Neisseria gonorrhoeae<\/i>and<i>Chlamydia trachomatis<\/i>infection among cisgender men who have sex with men"],"prefix":"10.1136","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2436-1022","authenticated-orcid":false,"given":"Emily","family":"Rowlinson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9743-0829","authenticated-orcid":false,"given":"Christine M.","family":"Khosropour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa E.","family":"Manhart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Golden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindley A.","family":"Barbee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"2024102610500796000_99.6.380.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6950a6"},{"key":"2024102610500796000_99.6.380.2","unstructured":"Centers for Disease Control and Prevention . Sexually transmitted disease surveillance 2019, 2021."},{"key":"2024102610500796000_99.6.380.3","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00007435-199704000-00001","article-title":"Positive screening tests for gonorrhea and chlamydial infection fail to lead consistently to treatment of patients attending a sexually transmitted disease clinic","volume":"24","author":"Schwebke","year":"1997","journal-title":"Sex Transm Dis"},{"key":"2024102610500796000_99.6.380.4","doi-asserted-by":"crossref","first-page":"e926","DOI":"10.1111\/jdv.17589","article-title":"The characteristics of men who have sex with men who present as sexual contacts of gonorrhoea from a clinic-based population","volume":"35","author":"Richardson","year":"2021","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2024102610500796000_99.6.380.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-015-1971-3","article-title":"High prevalence of rectal gonorrhoea among men reporting contact with men with gonorrhoea: implications for epidemiological treatment","volume":"15","author":"Dutt","year":"2015","journal-title":"BMC Public Health"},{"key":"2024102610500796000_99.6.380.6","doi-asserted-by":"crossref","first-page":"e3156","DOI":"10.1093\/cid\/ciaa1828","article-title":"Clinical factors associated with accurate presumptive treatment of Neisseria gonorrhoeae infections in men who have sex with men and transgender women","volume":"73","author":"Anker","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2024102610500796000_99.6.380.7","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1089\/lgbt.2017.0115","article-title":"Accuracy of presumptive gonorrhea treatment for gay, bisexual, and other men who have sex with men: results from a large sexual health clinic in Los Angeles, California","volume":"5","author":"Shover","year":"2018","journal-title":"LGBT Health"},{"key":"2024102610500796000_99.6.380.8","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001234"},{"key":"2024102610500796000_99.6.380.9","first-page":"37","volume-title":"Methods in molecular biology","volume":"1997","author":"Unemo","year":"2019"},{"key":"2024102610500796000_99.6.380.10","unstructured":"Centers for Disease Control and Prevention . Sexually transmitted disease surveillance 2019: gonococcal isolate surveillance project (GISP) supplement and profiles, 2021."},{"key":"2024102610500796000_99.6.380.11","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix249"},{"key":"2024102610500796000_99.6.380.12","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00309-10"},{"key":"2024102610500796000_99.6.380.13","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2021-055298"},{"key":"2024102610500796000_99.6.380.14","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.5858\/arpa.2020-0118-RA","article-title":"Point-Of-Care testing for sexually transmitted infections: a review of recent developments","volume":"144","author":"Adamson","year":"2020","journal-title":"Arch Pathol Lab Med"},{"key":"2024102610500796000_99.6.380.15","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1093\/cid\/ciab071","article-title":"The duration of pharyngeal gonorrhea: a natural history study","volume":"73","author":"Barbee","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2024102610500796000_99.6.380.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-020-4831-4","article-title":"Sti in times of PreP: high prevalence of Chlamydia, gonorrhea, and Mycoplasma at different anatomic sites in men who have sex with men in Germany","volume":"20","author":"Jansen","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2024102610500796000_99.6.380.17","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30304-4"},{"key":"2024102610500796000_99.6.380.18","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053613"},{"key":"2024102610500796000_99.6.380.19","doi-asserted-by":"publisher","DOI":"10.1177\/0956462418799181"},{"key":"2024102610500796000_99.6.380.20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/5758387","article-title":"Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature","volume":"2016","author":"Chan","year":"2016","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2024102610500796000_99.6.380.21","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1177\/0956462420975627","article-title":"Pharyngeal gonorrhoea in men who have sex with men","volume":"32","author":"Richardson","year":"2021","journal-title":"Int J STD AIDS"},{"key":"2024102610500796000_99.6.380.22","unstructured":"Sexually transmitted disease surveillance, 2020. 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