The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Wednesday, May 10, 2006
258

Trends of Chlamydia, Gonorrhea, and High-Titer Syphilis Among Men Who Have Sex With Men attending Whitman-Walker Clinic, Washington DC 2001-2004

Sukhminder Kaur Sandhu, Office of Workforce and Career Development, Centers for Disease Control and Prevention, 825 North Capitol Street, NE, 3rd Floor, Washington, DC, USA, Bruce Webster Furness, NCHSTP/DSTDP/ESB/FEU, CDC, 717 14th Street, NW, Suite 950 / Box 14, Washington, DC, USA, and Philipe A. Chiliade, Medical Services, Whitman-Walker Clinic, 1701 14th Street, NW, Washington, DC, USA.


Background:
Men who have sex with men (MSM) are at increased risk for multiple sexually transmitted diseases (STDs). Data on STDs among MSM in our nation's capital is limited. Whitman-Walker Clinic is a non-profit community-based health organization serving the Washington, D.C. metropolitan region that was established by and for the gay and lesbian community.

Objective:
To describe the temporal trends of chlamydia, gonorrhea, and syphilis among MSM attending Whitman-Walker Clinic for STD services.

Method:
As part of CDC's MSM Prevalence Monitoring Project, MSM tested for STDs at Whitman-Walker Clinic between January 2001-December 2004 were selected. Chlamydia results were only available from 2002-2004. Logistic regression was utilized to assess for overall linear trends in positive tests, among those tested, for syphilis, chlamydia and gonorrhea.

Result:
A total of 7,408 patient visits were recorded from 2001-2004, with annual total visits ranging from 1,692 to 1,953. Annually, the percentage of patient visits with tests for syphilis did not vary (range: 83.5%-86.2%), however there was a decline in the percentage of total patient visits with tests for gonorrhea (78.6% vs. 46.2%) and chlamydia (64.7% vs. 26.3%) from 2002 to 2004. Among persons tested, there was a significant linear increase (OR=1.5 [1.3-1.8]) in high-titer syphilis, but there were significant linear decreases in the percentage testing positive for chlamydia (OR=0.51 [0.27-0.96]) and gonorrhea [urethral (OR=0.88 [0.78-1.00]); rectal (OR=0.80 [0.65-0.99]); pharyngeal (OR=0.55 [0.35-0.86])].

Conclusion:
Although it appears chlamydia and gonorrhea has decreased among MSM tested at Whitman-Walker Clinic, the number of high-titer syphilis cases has increased. Risk factors for this increase need to be further evaluated.

Implications:
More research is needed to identify reasons for trends in STDs among MSM and also to identify appropriate interventions in Washington, D.C.