Comprehensive Molecular Screening in a Cohort of Young Men Who Have Sex With Men and Transgender Women: Effect of Additive Rectal Specimen Source Collection and Analyte Testing. Issue 11 (November 2020)

• Record Type: Journal Article
• Authors: Munson, Erik; Reynoso, Alyssa; Pass, Morena; Buehler, Kathleen; Ryan, Daniel; Clifford, Antonia; Morgan, Ethan; Mustanski, Brian
• Is Part Of: Sexually transmitted diseases. Volume 47:Issue 11(2020)
• Publication Date: 2020-11
• Subjects: Sexually transmitted diseases -- Periodicals; Sexual health -- Periodicals; 616.951005
• DOI: 10.1097/OLQ.0000000000001244
• Languages: English
• ISSNs: 0148-5717

Abstract

Abstract : Background: This study's purposes were to characterize detection rates of several sexually transmitted infection (STI) agents and describe the effect additional specimen source and analyte screening has on STI detection within a cohort of young men who have sex with men and transgender women. Methods: Within a 16-month interval, 1966 encounters involved dual urine and rectal swab submissions assessed by commercial transcription-mediated amplification–based assays for Chlamydia trachomatis and Neisseria gonorrhoeae and by off-label transcription-mediated amplification–based Trichomonas vaginalis and Mycoplasma genitalium testing. Identification of STI carriers used algorithms involving Food and Drug Administration–cleared screening methods, laboratory-modified testing for extraurogenital C. trachomatis and N. gonorrhoeae, and laboratory-developed tests for T. vaginalis and M. genitalium . Results: Food and Drug Administration–indicated urine C. trachomatis and N. gonorrhoeae screening revealed 39 encounters (2.0%) yielding one or both agents. Via C. trachomatis and N. gonorrhoeae screening that included rectal swab analysis, 264 encounters (13.4%) yielded evidence of either (140 C. trachomatis, 88 N. gonorrhoeae ) or both (36 participants) infections. Detection rates for C. trachomatis and N. gonorrhoeae were 1.4% and 0.6% for urine screening and 8.2% and 6.2% for rectal screening, respectively. Off-label screening identified 413 additional encounters with STI (5 T. vaginalis, 396 M. genitalium, 12 with both). Of these identifications, 82.1% were generated from analysis of rectal swabs (4 participants with T. vaginalis, 323 participants with M. genitalium, 12 with both). Overall detection rates of T. vaginalis (0.2% urine, 1.3% rectal) and M. genitalium (9.1% urine, 21.5% rectal) were variable. Conclusions: Additive analyte testing, including extraurogenital collections, contributes to comprehensive STI screening within a high-risk demographic. Abstract : Additive, non–Food and Drug Administration-cleared specimen (rectal swab) and analyte ( Trichomonas vaginalis and Mycoplasma genitalium ) screening identified 14-fold more sexually transmitted infection carriers in a cohort of young men who have sex with men and transgender women.