More Screening or More Disease? Gonorrhea Testing and Positivity Patterns Among Men in 3 Large Clinical Practices in Massachusetts, 2010–2017
| Autor: | Katherine K. Hsu, Heather Elder, Elaine W. Flagg, Brian Herrick, Myfanwy Callahan, Michelle Weiss, Michael Klompas, Julia L. Marcus, Karen Eberhardt, Sarah J Willis, Jessica G. Young, Ellen Hafer, Noelle M. Cocoros, Diana Erani, Eloisa Llata, Mark E. Josephson |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Microbiology (medical) Gonorrhea Disease urologic and male genital diseases 03 medical and health sciences 0302 clinical medicine Prevalence Humans Mass Screening Medicine 030212 general & internal medicine Homosexuality Male Online Only Articles Aged 030505 public health Gonorrhea test business.industry Chlamydia Infections medicine.disease Gonorrhea testing female genital diseases and pregnancy complications United States Confidence interval Test (assessment) Clinical Practice Infectious Diseases Massachusetts Relative risk 0305 other medical science business Demography |
| Zdroj: | Clin Infect Dis |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background Gonorrhea diagnosis rates in the United States increased by 75% during 2009–2017, predominantly in men. It is unclear whether the increase among men is being driven by more screening, an increase in the prevalence of disease, or both. We sought to evaluate changes in gonorrhea testing patterns and positivity among men in Massachusetts. Methods The analysis included men (aged ≥15 years) who received care during 2010–2017 in 3 clinical practice groups. We calculated annual percentages of men with ≥1 gonorrhea test and men with ≥1 positive result, among men tested. Log-binomial regression models were used to examine trends in these outcomes. We adjusted for clinical and demographic characteristics that may influence the predilection to test and probability of gonorrhea disease. Results On average, 306 348 men had clinical encounters each year. There was a significant increase in men with ≥1 gonorrhea test from 2010 (3.1%) to 2017 (6.4%; adjusted annual risk ratio, 1.12; 95% confidence interval, 1.12–1.13). There was a significant, albeit lesser, increase in the percentage of tested men with ≥1 positive result (1.0% in 2010 to 1.5% in 2017; adjusted annual risk ratio, 1.07; 95% confidence interval, 1.04–1.09). Conclusions We estimated significant increases in the annual percentages of men with ≥1 gonorrhea test and men with ≥1 positive gonorrhea test result between 2010 and 2017. These results suggest that observed increases in gonorrhea rates could be explained by both increases in screening and the prevalence of gonorrhea. |
| Databáze: | OpenAIRE |
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