{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:39:06Z","timestamp":1793295546354,"version":"4.5.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:p>\n                    Routine high-frequency screening for asymptomatic\n                    <jats:italic toggle=\"yes\">Chlamydia trachomatis<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">Neisseria gonorrhoeae<\/jats:italic>\n                    among cisgender gay, bisexual and other men who have sex with men (gbMSM) is established despite limited evidence that it reduces population-level incidence or harm. Recent studies support reconsideration but do not settle the balance of benefits and harms. Reducing screening could delay diagnosis and affect transmission or partner notification; continuing screening may increase antimicrobial exposure, possible overdiagnosis, anxiety and stigma. The demonstrated benefits and unresolved long-term stewardship implications of doxycycline post-exposure prophylaxis (DoxyPEP) illustrate why antimicrobial use should be differentiated. We argue for cautious, co-produced, evaluated and reversible de-implementation while maintaining symptomatic, contact-based and otherwise clinically indicated testing, HIV and syphilis screening and HIV pre-exposure prophylaxis (PrEP) care. With transparent communication and community partnership, less screening need not mean less care.\n                  <\/jats:p>","DOI":"10.1177\/09564624261481866","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:38:02Z","timestamp":1787787482000},"page":"1214-1217","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Less is more: reconsidering asymptomatic\n                    <i>Chlamydia trachomatis<\/i>\n                    and\n                    <i>Neisseria gonorrhoeae<\/i>\n                    screening for gay, bisexual and other men who have sex with men in the era of doxycycline post-exposure prophylaxis (DoxyPEP)"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3429-0611","authenticated-orcid":false,"given":"David James","family":"Field","sequence":"first","affiliation":[{"name":"University of Aberdeen"},{"name":"Health Service Executive"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny","family":"Boylan","sequence":"additional","affiliation":[{"name":"Health Service Executive"},{"name":"St James\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Lyons","sequence":"additional","affiliation":[{"name":"St James\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Hurley O\u2019Dwyer","sequence":"additional","affiliation":[{"name":"Health Service Executive"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Den Daas","sequence":"additional","affiliation":[{"name":"University of Aberdeen"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.171154"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/09564624261457470"},{"key":"e_1_3_3_4_2","volume-title":"Paradigmashift chlamydia","author":"National Institute for Public Health and the Environment (RIVM)","year":"2024","unstructured":"National Institute for Public Health and the Environment (RIVM). Paradigmashift chlamydia, 2024. https:\/\/lci.rivm.nl\/richtlijnen\/chlamydia-trachomatis-en-lymfogranuloma-venereum\/paradigmashift (accessed 4 August 2026)."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/09564624251323678"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000824"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2471\/B09199"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(23)00299-0"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanmic.2025.101214"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3502"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2020-054500"},{"issue":"4","key":"e_1_3_3_12_2","first-page":"219","article-title":"Spontaneous clearance of asymptomatic anogenital and pharyngeal Neisseria gonorrhoeae: a secondary analysis from the NABOGO trial","volume":"99","author":"Teker B","year":"2023","unstructured":"Teker B, De Vries HJC, Heijman T, et al. Spontaneous clearance of asymptomatic anogenital and pharyngeal Neisseria gonorrhoeae: a secondary analysis from the NABOGO trial. Sex Transm Infect 2023; 99(4): 219\u2013225. https:\/\/doi.org\/10.1136\/sextrans-2022-055488","journal-title":"Sex Transm Infect"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2524944122"},{"key":"e_1_3_3_14_2","doi-asserted-by":"crossref","unstructured":"Field DJ De Wit J Dixon D et al. Risk reconsidered: insights from a data saturation analysis of sexual health research amongst gay bisexual and other men who have sex with men. Cult Health Sex Epub ahead of print 11 October 2025. https:\/\/doi.org\/10.1080\/13691058.2025.2567290","DOI":"10.1080\/13691058.2025.2567290"},{"key":"e_1_3_3_15_2","doi-asserted-by":"crossref","unstructured":"Field DJ Ghiglieri C De Wit J et al. Making sense of risk: an interpretative phenomenological analysis of risk related to STIs and HIV among Irish gay men. 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