Modest rise in chlamydia and gonorrhoea testing did not increase case detection in a clinical HIV cohort in Ontario, Canada


OBJECTIVES We described patterns of testing for chlamydia and gonorrhoea infection among persons in specialty HIV care in Ontario, Canada, from 2008 to 2011. METHODS We analysed data from 3165 participants in the OHTN Cohort Study attending one of seven specialty HIV care clinics. We obtained chlamydia and gonorrhoea test results via record linkage with the provincial public health laboratory. We estimated the proportion of participants who underwent testing annually, the positivity rate among those tested and the proportion diagnosed with chlamydia or gonorrhoea among all under observation. We explored risk factors for testing and diagnosis using multiple logistic regression analysis. RESULTS The proportion tested annually rose from 15.2% (95% CI 13.6% to 16.7%) in 2008 to 27.0% (95% CI 25.3% to 28.6%) in 2011 (p<0.0001). Virtually all were urine-based nucleic acid amplification tests. Testing was more common among men who have sex with men (MSM), younger adults, Toronto residents, persons attending primary care clinics and persons who had tested in the previous year or who had more clinic visits in the current year. We observed a decrease in test positivity rates over time. However, the annual proportion diagnosed remained stable and in 2011 this was 0.97% (95% CI 0.61% to 1.3%) and 0.79% (95% CI 0.46% to 1.1%) for chlamydia and gonorrhoea, respectively. Virtually all cases were among MSM. CONCLUSIONS Chlamydia and gonorrhoea testing increased over time while test positivity rates declined and the overall proportion diagnosed remained stable, suggesting that the modest increase in testing did not improve case detection.

DOI: 10.1136/sextrans-2014-051647

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@inproceedings{Burchell2014ModestRI, title={Modest rise in chlamydia and gonorrhoea testing did not increase case detection in a clinical HIV cohort in Ontario, Canada}, author={Ann N. Burchell and Ramandip Grewal and Vanessa G. Allen and Sandra L. Gardner and Veronika Moravan and Ahmed M. Bayoumi and Rupert Kaul and Frank McGee and Margaret E Millson and Robert S . Remis and Janet M. Raboud and Tony Mazzulli and Sean B Rourke and Sergio Rueda and Kevin A Gough and Darrell H S Tan and Jeffrey Cohen and Curtis L. Cooper and Don Kilby and Mona Loutfy and Fred Crouzat and Anita Rochelle Rachlis and Nicole Mittmann and Irving Elliot Salit and Edward D. Ralph and Roger Sandre and Marek Smieja and Wendy L. Wobeser}, booktitle={Sexually transmitted infections}, year={2014} }