{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:09:42Z","timestamp":1793232582529,"version":"4.5.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"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":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>\n                    Evidence from real-world studies suggests that 3-monthly screening for asymptomatic chlamydia\/gonorrhea is not reducing incidence and is driving increased antibiotic use and antimicrobial resistance (AMR). While some countries are recommending less screening, changes to guidelines require clinician buy-in. This study explored the views of Australian sexual health clinicians on changing practices around asymptomatic screening for chlamydia\/gonorrhea in gay, bisexual, and other men-who-have-sex-with-men and attitudes to not automatically treating positive diagnoses. Between September and December 2024, we conducted thematic analysis of semi-structured interviews with 12 physicians (including 8 general practitioners) and 4 nurse practitioners working in sexual health centers, hospitals, Aboriginal health services, general practice, and nongovernmental organizations. Clinicians had variable knowledge about the limited effectiveness of asymptomatic screening. Many were open to reduced screening if provided supporting evidence. Given challenges in reducing medical interventions, they recommended public education to drive changes. While some clinicians supported patient dialogue in treatment decision-making, most felt uncomfortable\n                    <jats:italic toggle=\"yes\">not<\/jats:italic>\n                    treating. Key concerns included ideas about their role as doctors, onward transmission (particularly to women), and complications\/uncomfortable symptoms\/patient psychological well-being. AMR considerations were less salient. While the \u201ctest and treat\u201d paradigm is engrained, clinicians were open to reduced screening if provided with clear evidence but were generally reluctant to not treat. A flexible approach that supports patient empowerment in decision-making about screening frequency and choices around treatment could present a way forward. Changing practice requires education to shift patient\/clinician mindsets around what it means to have a positive chlamydia\/gonorrhea diagnosis.\n                  <\/jats:p>","DOI":"10.1177\/10872914251399618","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T08:23:52Z","timestamp":1763713432000},"page":"31-37","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Are Clinicians Open to Less Asymptomatic STI Screening for Chlamydia and Gonorrhea in Gay, Bisexual, and Other Men Who Have Sex with Men and the Possibility of Not Treating Positive Diagnoses? A Qualitative Study from Australia"],"prefix":"10.1177","volume":"40","author":[{"given":"Teralynn","family":"Ludwick","sequence":"first","affiliation":[{"name":"Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tin D.","family":"Vo","sequence":"additional","affiliation":[{"name":"Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Ware","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan T.","family":"Cardwell","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Riley","sequence":"additional","affiliation":[{"name":"ASHM Health, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric P.F.","family":"Chow","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia."},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Coombe","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Grace","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane S.","family":"Hocking","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian Y.S.","family":"Kong","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/09564624251333489"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1071\/SH19061"},{"key":"e_1_3_2_4_2","unstructured":"ASHM. 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Available from: https:\/\/www.cdc.gov\/mmwr\/volumes\/70\/rr\/rr7004a1.htm","DOI":"10.12788\/jfp.0318"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002020"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00356-0"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(24)00037-7"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix326"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.07.010"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.17955.1"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(23)00299-0"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2407.172104"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab1022"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab071"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052399"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2020-054764"},{"key":"e_1_3_2_19_2","unstructured":"World Health Organization. WHO Bacterial Priority Pathogens List 2024: Bacterial pathogens of public health importance to guide research development and strategies to prevent and control antimicrobial resistance. Geneva 2024. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240093461"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1465628"},{"key":"e_1_3_2_21_2","first-page":"101663","article-title":"Antimicrobial resistance in Neisseria gonorrhoeae in nine sentinel countries within the World Health Organization Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), 2023: A retrospective observational study","volume":"61","author":"Maatouk I","year":"2025","unstructured":"Maatouk I, , Vumbugwa P, , Cherdtrakulkiat T, et al.; WHO EGASP Study Group. Antimicrobial resistance in Neisseria gonorrhoeae in nine sentinel countries within the World Health Organization Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP), 2023: A retrospective observational study. Lancet Reg Health West Pac, 2025; 61:101663.","journal-title":"Lancet Reg Health West Pac"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/09564624231190108"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2024.02.017"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00528-0"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1101\/2025.10.15.25337958"},{"key":"e_1_3_2_26_2","volume-title":"Victoria. Thematic Analysis: A Practical Guide","author":"Braun VC","year":"2021","unstructured":"Braun VC. Victoria. Thematic Analysis: A Practical Guide: SAGE Publications; 2021."},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2010.01562.x"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4706-9"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112643"},{"key":"e_1_3_2_30_2","first-page":"sextrans","article-title":"\u2018It does fill me with a bit of unease\u2019: A qualitative study of the acceptability, facilitators and barriers to reducing the frequency of screening for asymptomatic sexually transmitted infections among gay, bisexual and other men who have sex with men","author":"Berners-Lee W","year":"2025","unstructured":"Berners-Lee W, , Cabecinha M, , Bell J, et al. \u2018It does fill me with a bit of unease\u2019: A qualitative study of the acceptability, facilitators and barriers to reducing the frequency of screening for asymptomatic sexually transmitted infections among gay, bisexual and other men who have sex with men. 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