Background:
The Health and Human Services Region VIII (HHSVIII) infertility prevention program, consisting of the STD Prevention programs, Women's Health programs and Public Health Laboratories of Colorado, Utah, Wyoming, Montana, North and South Dakota have collaborated on effort to reduce Chlamydia trachomatis (CT) infection since 1992. Nucleic acid amplification testing (NAAT) for urine specimens for males attending clinics supported by this program was initiated during the period of 1995-2003.

Objective:
To determine the number and type of specimens submitted for CT testing by NAAT methods in both asymptomatic and symptomatic males, the overall positivity rates and the impact of NAAT testing on positivity rates in males and females in the region during the period 1995-2005.

Method:
Data on male testing reported by HHSVIII participating laboratories was analyzed for the total number of male urines submitted for testing by year, as well as the method used for testing. Data was not revised to remove multiple specimens from the same individual.

Result:
Testing of urine specimens from males increased nearly 37-fold while male urethral specimens decreased by nearly 90% during the study period. During the period of 1999-2005, 85,740 urine specimens were submitted for NAAT testing, consisting of 54,431 from self-reported asymptomatic males and 31,299 from symptomatic males. The positivity rates were 8.1% and 27.0% respectively. Testing of asymptomatic males increased more than three-fold during this period.

Conclusion:
Urine testing of males for CT has become the predominant screening method in HHSVIII supplanting urethral specimen testing. Testing of males, both symptomatic and asymptomatic, has increased but no impact on female positivity rates has been discerned to date.

Implications:
The effects of this trend toward increased testing of males should be monitored for possible favorable outcomes for reduction of CT prevalence in females.