{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:05:06Z","timestamp":1784196306720,"version":"3.55.0"},"reference-count":22,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000085","name":"Ontario HIV Treatment Network","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000085","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100032514","name":"Public Health Ontario","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100032514","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,9,30]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      We sought to determine positivity rates for participants in the GetaKit study who identified as asymptomatic contacts of\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      (NG) and\/or\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      (CT). Our goal was to shed light on current discrepancies between international sexually transmitted infection (STI) guidelines, some of which recommend blanket empiric treatment for all NG and CT contacts (eg, Canadian and United States guidelines) versus others which recommend waiting for positive results (BASHH, Australian, and European).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted data for the period of 1 June 2023 to 30 June 2025 from GetaKit, which is a research website through which persons in Ontario, Canada can complete an online risk assessment and obtain access to laboratory-based testing for STIs, including NG, CT, HIV, syphilis and hepatitis C. From these data, we calculated positivity rates for NG and CT and the numbers needed to treat. We also evaluated for correlations of risk factors for testing positive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During our 25-month study period, participants ordered NG\/CT testing 12\u2009775 times. In a total of 6.7% of these orders, participants identified as an NG and\/or CT contact. Positivity rates, for all completed testing, were 1.2% (n=115 diagnoses) for NG and 4.3% (n=395 diagnoses) for CT. Positivity among asymptomatic contacts ranged from 0% for NG in heterosexual males to 30.6% for CT in females who were \u226424 years old, with most positivity rates being &lt;20% for both infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest that blanket recommendations to treat or defer treatment seems inappropriate. More nuance is required. Empiric treatment of all NG and CT contacts will likely result in mass overuse of antibiotics. In contrast, deferring treatment seems inappropriate for asymptomatic females who are \u226424 years old and for anyone who cannot immediately obtain testing and treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056697","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T17:21:36Z","timestamp":1760548896000},"page":"278-283","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Should we still treat asymptomatic\n                    <i>Neisseria gonorrhoeae<\/i>\n                    and\n                    <i>Chlamydia trachomatis<\/i>\n                    contacts in the era of NAATs? Reviewing data from the GetaKit study to inform practice"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-1409","authenticated-orcid":false,"given":"Patrick","family":"O\u2019Byrne","sequence":"first","affiliation":[{"name":"School of Nursing, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Ottawa Public Health, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Orser","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Ottawa Public Health, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"2026071602100844000_102.5.278.1","unstructured":"Public Health Agency of Canada . Canadian guidelines on sexually transmitted infections. 2025. Available: https:\/\/www.canada.ca\/en\/public-health\/services\/infectious-diseases\/sexual-health-sexually-transmitted-infections\/canadian-guidelines\/chlamydia-lgv\/treatment-follow-up.html#a4"},{"key":"2026071602100844000_102.5.278.2","unstructured":"Public Health Agency of Canada . Gonorrhea guide: treatment and follow-up. 2025. Available: https:\/\/www.canada.ca\/en\/public-health\/services\/infectious-diseases\/sexual-health-sexually-transmitted-infections\/canadian-guidelines\/gonorrhea\/treatment-follow-up.html#a8"},{"key":"2026071602100844000_102.5.278.3","unstructured":"United States Centers for Disease Control . Sexually transmitted infections treatment guidelines. 2021. Available: https:\/\/www.cdc.gov\/std\/treatment-guidelines\/toc.htm"},{"key":"2026071602100844000_102.5.278.4","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1177\/09564624251345195","article-title":"British Association of Sexual Health and HIV UK National Guideline for the Management of infection with Neisseria gonorrhoeae, 2025","volume":"36","author":"Fifer","year":"2025","journal-title":"Int J STD AIDS"},{"key":"2026071602100844000_102.5.278.5","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1177\/09564624251323678","article-title":"2025 European guideline on the management of Chlamydia trachomatis infections","volume":"36","author":"White","year":"2025","journal-title":"Int J STD AIDS"},{"key":"2026071602100844000_102.5.278.6","unstructured":"Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine (ASHM) . Australian sti management guidelines for use in primary care. 2025. Available: https:\/\/sti.guidelines.org.au"},{"key":"2026071602100844000_102.5.278.7","doi-asserted-by":"crossref","first-page":"e627","DOI":"10.1016\/S2666-5247(21)00171-3","article-title":"WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017\u201318: a retrospective observational study","volume":"2","author":"Unemo","year":"2021","journal-title":"The Lancet Microbe"},{"key":"2026071602100844000_102.5.278.8","unstructured":"Public Health Ontario . Chlamydia trachomatis and neisseria gonorrhoeae - nucleic acid amplification testing. 2022. Available: https:\/\/www.publichealthontario.ca\/-\/media\/documents\/lab\/lab-sd-005-chlamydia-gonorrhoeae-sensitivity-specificity.pdf"},{"key":"2026071602100844000_102.5.278.9","doi-asserted-by":"crossref","unstructured":"O\u2019Byrne P , Orser L , Watson C , et al . Modernizing Public Health STI and HIV Testing Services in Ontario: The GetaKit Project. 12. HRO, 2025.Available: https:\/\/doi.org\/10.13162\/hro-ors.v12i1.5879","DOI":"10.13162\/hro-ors.v12i1.5879"},{"key":"2026071602100844000_102.5.278.10","unstructured":"Public Health Ontario . Chlamydia trachomatis\/neisseria gonorrhoeae (CT\/NG) \u2013 nucleic acid amplification testing (naat). 2024. Available: https:\/\/www.publichealthontario.ca\/en\/Laboratory-Services\/Test-Information-Index\/Chlamydia-trachomatis-NAAT-Swabs"},{"key":"2026071602100844000_102.5.278.11","doi-asserted-by":"publisher","DOI":"10.1177\/09564624211031322"},{"key":"2026071602100844000_102.5.278.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-020-05148-7","article-title":"Sensitivity, specificity, inclusivity and exclusivity of the updated Aptima Combo 2 assay, which provides detection coverage of the new diagnostic-escape Chlamydia trachomatis variants","volume":"20","author":"Unemo","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2026071602100844000_102.5.278.13","unstructured":"Statistics Canada . Visible minority and population group reference guide. Census of Population; 2021. Available: https:\/\/www12.statcan.gc.ca\/census-recensement\/2021\/ref\/98-500\/006\/98-500-x2021006-eng.cfm"},{"key":"2026071602100844000_102.5.278.14","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053364"},{"key":"2026071602100844000_102.5.278.15","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/OLQ.0000000000001234","article-title":"Epidemiologic Treatment for Contacts to Neisseria gonorrhoeae and Chlamydia trachomatis Infection in Sexually Transmitted Disease Clinic Patients in Seattle, WA; 1994 to 2018","volume":"47","author":"Rowlinson","year":"2020","journal-title":"Sexual Trans Dis"},{"key":"2026071602100844000_102.5.278.16","doi-asserted-by":"publisher","DOI":"10.1177\/0956462418799181"},{"key":"2026071602100844000_102.5.278.17","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v46i09a06"},{"key":"2026071602100844000_102.5.278.18","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz429"},{"key":"2026071602100844000_102.5.278.19","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1177\/0956462420956852","article-title":"Managing contacts of chlamydia: should clinics implement a test and wait process?","volume":"32","author":"Frackelton","year":"2021","journal-title":"Int J STD AIDS"},{"key":"2026071602100844000_102.5.278.20","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1089\/jwh.2025.0123","article-title":"Pharyngeal Chlamydia trachomatis Screening in Women: A Retrospective Study","volume":"34","author":"Berber","year":"2025","journal-title":"J Womens Health (Larchmt)"},{"key":"2026071602100844000_102.5.278.21","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0140297","article-title":"Prevalence of and Factors Associated with Rectal-Only Chlamydia and Gonorrhoea in Women and in Men Who Have Sex with Men","volume":"10","author":"van Liere","year":"2015","journal-title":"PLoS One"},{"key":"2026071602100844000_102.5.278.22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2211934"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056697","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:10:56Z","timestamp":1784193056000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,15]]},"references-count":22,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,7,16]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/sextrans-2025-056697"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056697","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,15]]}}}