Predictors of High Chlamydial and Gonococcal Prevalence Among Men in the Southern United States

Background:
Chlamydial (CT) and gonococcal (GC) infection screening is not routinely recommended in males, but is performed in certain venues. Males may serve as reservoirs for CT and GC in females.

Objective:
To describe epidemiologic patterns of CT and GC prevalences among males in the Southern U.S.

Method:
Data were derived from the Infertility Prevention Project and consisted of 603,320 males 15 to 60 years old undergoing CT and GC screening in STD, family planning, correctional, college and other facilities in AL, AK, FL, GA, KY, LA, MS, NM, OK, SC, TN and TX between 2001 and 2005. Infections were diagnosed by either Gen-Probe (GP) PACE 2C or APTIMA COMBO (AC) 2® Assays (Gen-Probe, Inc., San Diego, CA). Analyses were performed on SPSS version 15 (SPSS Inc, Chicago, Illinois).

Result:
Overall, CT and GC prevalences were both 13%. Between 2001 and 2005, CT prevalence increased 32% and GC prevalence decreased 28%. With increasing age, CT prevalence decreased while GC prevalence remained stable. In men <30 years old, both CT and GC prevalences were significantly higher than men ≥30 years old (P <.01). Males were primarily African American (62%) or Caucasian (37%); 10% were Hispanic. African Americans had a 5-fold higher risk for GC and 1.5 fold higher risk for CT than Caucasians (P <.001). Men living in ten selected metropolitan areas had a 1.24 fold higher risk for GC than men living in other areas (P <.01). CT prevalence was higher in the Southeast and GC prevalence was higher in South Central states. The GC prevalence was low in correctional facilities.

Conclusion:
CT and GC prevalences were high in males and were influenced by demographical and geographical factors.

Implications:
More strategies are needed for male screening.