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Background: Annual screening for chlamydia and gonorrhea is recommended for sexually active men who have sex with men (MSM) at sites of contact (urethra, rectum, pharynx (gonorrhea only)) regardless of condom use.
Methods: We assessed differences in self-reported chlamydia and gonorrhea testing and diagnosis in the past 12 months among MSM using National HIV Behavioral Surveillance data from 2011 and 2014. MSM who had ≥ 1 partner in the past 12 months were included in analyses. Analyses of chlamydia and gonorrhea diagnosis data were limited to participants who reported chlamydia and gonorrhea screening, respectively. Differences in testing and diagnosis over time were assessed using Poisson regression models with robust standard errors separately for chlamydia and gonorrhea. To explore whether temporal changes in the outcomes varied by demographics, interaction terms were included in the models.
Results: Analyses included data from 18,896 MSM (2011: n=9,256; 2014: n=9,640). Testing for chlamydia increased from 38% in 2011 to 47% in 2014 (aPR: 1.19, 95% CI: 1.15-1.24) and for gonorrhea from 39% to 48% (aPR: 1.18, 95% CI: 1.14-1.22). Testing for each increased among most demographic sub-groups. Chlamydia diagnoses increased from 9% in 2011 to 11% in 2014 (aPR: 1.48, 95% CI: 1.28-1.70). Larger increases were observed among MSM in the white and ‘other’ racial categories, those with more education, and HIV-positive MSM. Gonorrhea diagnoses increased from 12% in 2011 to 15% in 2014 (aPR: 1.51, 95% CI: 1.33-1.71). Larger increases were observed among MSM in the white and ‘other’ racial categories and those with more education, health insurance, and more sex partners in the past 12 months.
Conclusions: Diagnoses of both chlamydia and gonorrhea increased beyond the magnitude of the increases in testing between 2011 and 2014 after adjustment. Increased efforts are needed to meet annual STD screening recommendations among MSM at high risk for HIV.