International Society for Sexually Transmitted Diseases Research (ISSTDR): 19th Meeting

QUEBEC CITY – Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis peak at different ages, based on data from 386 young women.

Age-specific incidence rates of these three sexually transmitted infections (STIs) in young women have not been well studied, said Wanzhu Tu, Ph.D., of Indiana University, Indianapolis, and colleagues.

In a longitudinal cohort study, the researchers recruited young women aged 14-17 years from three adolescent medicine clinics. The participants completed questionnaires and face-to-face interviews to determine lifetime and recent sexual activity; cervical and vaginal specimens were collected and tested.

Participants were interviewed and tested for STIs every 3 months. The average length of follow-up was 3.5 years. Any participants with positive tests received treatment, according to the findings presented in a poster session at a congress of the International Society for Sexually Transmitted Diseases Research.

The separate baseline prevalence rates for chlamydia, gonorrhea, and trichomoniasis were 11%, 4%, and 6%, respectively.

The combined peak incidence of any of the three infections was approximately 15% at age 20 years.

When the separate incidence of the three infections was examined as a function of age, chlamydia incidence rose gradually from 7% at age 14 years, peaked at approximately 18 years (11%), and then steadily declined to almost 1% at age 24 years. Gonorrhea rose from 1% at age 14 years, peaked at approximately 19 years (4%), and declined gradually to almost 0% until age 24 years. By contrast, the incidence of trichomoniasis infections started slightly above 1% at age 14 years, peaked at approximately 21 years (6%), and remained steady through age 24 years.

The average age of the participants was 15 years, the average age at the time of sexual debut was 14 years, and the average number of sexual partners at study enrollment was three. A total of 89% of the participants were black.

"The estimated STI incidence rates clearly differ by organism, not only in magnitude but also in peak age," the researchers noted.

"Prevalences of the respective organisms in the partner population are likely contributors to the differential risk of STI acquisition," they added. However, the fact that the differences were seen within the same group of young women with relatively few sexual partners suggests that biologically determined differences in age-related susceptibility may play a large role in STI infections, they said.

The researchers said they had no relevant financial disclosures.

For more information about STIs in teens, check out the latest statistics at the Centers for Disease Control and Prevention website.

QUEBEC CITY – Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis peak at different ages, based on data from 386 young women.

Age-specific incidence rates of these three sexually transmitted infections (STIs) in young women have not been well studied, said Wanzhu Tu, Ph.D., of Indiana University, Indianapolis, and colleagues.

In a longitudinal cohort study, the researchers recruited young women aged 14-17 years from three adolescent medicine clinics. The participants completed questionnaires and face-to-face interviews to determine lifetime and recent sexual activity; cervical and vaginal specimens were collected and tested.

Participants were interviewed and tested for STIs every 3 months. The average length of follow-up was 3.5 years. Any participants with positive tests received treatment, according to the findings presented in a poster session at a congress of the International Society for Sexually Transmitted Diseases Research.

The separate baseline prevalence rates for chlamydia, gonorrhea, and trichomoniasis were 11%, 4%, and 6%, respectively.

The combined peak incidence of any of the three infections was approximately 15% at age 20 years.

When the separate incidence of the three infections was examined as a function of age, chlamydia incidence rose gradually from 7% at age 14 years, peaked at approximately 18 years (11%), and then steadily declined to almost 1% at age 24 years. Gonorrhea rose from 1% at age 14 years, peaked at approximately 19 years (4%), and declined gradually to almost 0% until age 24 years. By contrast, the incidence of trichomoniasis infections started slightly above 1% at age 14 years, peaked at approximately 21 years (6%), and remained steady through age 24 years.

The average age of the participants was 15 years, the average age at the time of sexual debut was 14 years, and the average number of sexual partners at study enrollment was three. A total of 89% of the participants were black.

"The estimated STI incidence rates clearly differ by organism, not only in magnitude but also in peak age," the researchers noted.

"Prevalences of the respective organisms in the partner population are likely contributors to the differential risk of STI acquisition," they added. However, the fact that the differences were seen within the same group of young women with relatively few sexual partners suggests that biologically determined differences in age-related susceptibility may play a large role in STI infections, they said.

The researchers said they had no relevant financial disclosures.

For more information about STIs in teens, check out the latest statistics at the Centers for Disease Control and Prevention website.

QUEBEC CITY – Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis peak at different ages, based on data from 386 young women.

Age-specific incidence rates of these three sexually transmitted infections (STIs) in young women have not been well studied, said Wanzhu Tu, Ph.D., of Indiana University, Indianapolis, and colleagues.

In a longitudinal cohort study, the researchers recruited young women aged 14-17 years from three adolescent medicine clinics. The participants completed questionnaires and face-to-face interviews to determine lifetime and recent sexual activity; cervical and vaginal specimens were collected and tested.

Participants were interviewed and tested for STIs every 3 months. The average length of follow-up was 3.5 years. Any participants with positive tests received treatment, according to the findings presented in a poster session at a congress of the International Society for Sexually Transmitted Diseases Research.

The separate baseline prevalence rates for chlamydia, gonorrhea, and trichomoniasis were 11%, 4%, and 6%, respectively.

The combined peak incidence of any of the three infections was approximately 15% at age 20 years.

When the separate incidence of the three infections was examined as a function of age, chlamydia incidence rose gradually from 7% at age 14 years, peaked at approximately 18 years (11%), and then steadily declined to almost 1% at age 24 years. Gonorrhea rose from 1% at age 14 years, peaked at approximately 19 years (4%), and declined gradually to almost 0% until age 24 years. By contrast, the incidence of trichomoniasis infections started slightly above 1% at age 14 years, peaked at approximately 21 years (6%), and remained steady through age 24 years.

The average age of the participants was 15 years, the average age at the time of sexual debut was 14 years, and the average number of sexual partners at study enrollment was three. A total of 89% of the participants were black.

"The estimated STI incidence rates clearly differ by organism, not only in magnitude but also in peak age," the researchers noted.

"Prevalences of the respective organisms in the partner population are likely contributors to the differential risk of STI acquisition," they added. However, the fact that the differences were seen within the same group of young women with relatively few sexual partners suggests that biologically determined differences in age-related susceptibility may play a large role in STI infections, they said.

The researchers said they had no relevant financial disclosures.

For more information about STIs in teens, check out the latest statistics at the Centers for Disease Control and Prevention website.

QUEBEC CITY – Women with a history of chlamydia were significantly more likely to get retested if they could collect samples at home rather than having to visit a clinic, based on data from 404 women.

Women with recurrent chlamydia infections can be at increased risk for long-term complications, but few women comply with the Centers for Disease Control and Prevention recommendation for chlamydia rescreening 3 months after an initial treatment, Dr. Fujie Xu of the CDC said during a presentation of the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

"The need for a clinic visit and a vaginal speculum examination likely contribute to poor compliance with the rescreening recommendation," she said.

Dr. Xu and her colleagues surmised that offering women at-home testing instead of a clinic visit might increase rescreening rates.

They were right. The study’s primary end point was the rescreening rate during a 7-week window from 1 week before to 6 weeks after a date of 3 months past the patient’s initial treatment. A total of 80 of 196 women (41%) randomized to perform a home test were rescreened, compared with 43 of 208 women (21%) randomized to a follow-up clinic visit. The difference was statistically significant.

Women in the take-home group also were significantly more likely to be rescreened at any point during the study, compared with the clinic group (49% vs. 28%).

The women were recruited from Jackson, Miss., New Orleans, and St. Louis. The average age of the women was 21 years; 85% of the home test group and 88% of the clinic test group were black. The education levels were similar between the two groups. All study participants had previously tested positive for chlamydia.

When the researchers analyzed the findings by demographic factors, women in the at-home test group who had a high school eduction or less were significantly more likely to be rescreened than were similarly educated women in the clinic group. For women who had some college education, there was no significant difference in screening rates between the at-home test and clinic test groups.

At the rescreening visits, 93 specimens from home test patients and 55 from clinic test patients were tested. The percentage of positive tests upon rescreening was similar between the groups: 13% in the home group and 15% in the clinic group.

Overall, rescreening rates were almost twice as high in the at-home test group as in the clinic group, Dr. Xu said. In several study subgroups, rescreening rates were consistently higher among women who used home tests, compared with clinic tests, she added.

Home testing for chlamydia represents a new tool, "but not the magic bullet," Dr. Xu said. More research is needed to identify better ways to remind patients to get rescreened for chlamydia, and more support is needed for FDA-approved tests for home specimen collection, she said.

Additional data from this study were published online in the August issue of Obstetrics & Gynecology (2011 August;118:231-239 [doi: 10.1097/AOG.0b013e3182246a83]).

Dr. Xu said that she had no financial conflicts to disclose.

QUEBEC CITY – Women with a history of chlamydia were significantly more likely to get retested if they could collect samples at home rather than having to visit a clinic, based on data from 404 women.

Women with recurrent chlamydia infections can be at increased risk for long-term complications, but few women comply with the Centers for Disease Control and Prevention recommendation for chlamydia rescreening 3 months after an initial treatment, Dr. Fujie Xu of the CDC said during a presentation of the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

"The need for a clinic visit and a vaginal speculum examination likely contribute to poor compliance with the rescreening recommendation," she said.

Dr. Xu and her colleagues surmised that offering women at-home testing instead of a clinic visit might increase rescreening rates.

They were right. The study’s primary end point was the rescreening rate during a 7-week window from 1 week before to 6 weeks after a date of 3 months past the patient’s initial treatment. A total of 80 of 196 women (41%) randomized to perform a home test were rescreened, compared with 43 of 208 women (21%) randomized to a follow-up clinic visit. The difference was statistically significant.

Women in the take-home group also were significantly more likely to be rescreened at any point during the study, compared with the clinic group (49% vs. 28%).

The women were recruited from Jackson, Miss., New Orleans, and St. Louis. The average age of the women was 21 years; 85% of the home test group and 88% of the clinic test group were black. The education levels were similar between the two groups. All study participants had previously tested positive for chlamydia.

When the researchers analyzed the findings by demographic factors, women in the at-home test group who had a high school eduction or less were significantly more likely to be rescreened than were similarly educated women in the clinic group. For women who had some college education, there was no significant difference in screening rates between the at-home test and clinic test groups.

At the rescreening visits, 93 specimens from home test patients and 55 from clinic test patients were tested. The percentage of positive tests upon rescreening was similar between the groups: 13% in the home group and 15% in the clinic group.

Overall, rescreening rates were almost twice as high in the at-home test group as in the clinic group, Dr. Xu said. In several study subgroups, rescreening rates were consistently higher among women who used home tests, compared with clinic tests, she added.

Home testing for chlamydia represents a new tool, "but not the magic bullet," Dr. Xu said. More research is needed to identify better ways to remind patients to get rescreened for chlamydia, and more support is needed for FDA-approved tests for home specimen collection, she said.

Additional data from this study were published online in the August issue of Obstetrics & Gynecology (2011 August;118:231-239 [doi: 10.1097/AOG.0b013e3182246a83]).

Dr. Xu said that she had no financial conflicts to disclose.

QUEBEC CITY – Women with a history of chlamydia were significantly more likely to get retested if they could collect samples at home rather than having to visit a clinic, based on data from 404 women.

Women with recurrent chlamydia infections can be at increased risk for long-term complications, but few women comply with the Centers for Disease Control and Prevention recommendation for chlamydia rescreening 3 months after an initial treatment, Dr. Fujie Xu of the CDC said during a presentation of the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

"The need for a clinic visit and a vaginal speculum examination likely contribute to poor compliance with the rescreening recommendation," she said.

Dr. Xu and her colleagues surmised that offering women at-home testing instead of a clinic visit might increase rescreening rates.

They were right. The study’s primary end point was the rescreening rate during a 7-week window from 1 week before to 6 weeks after a date of 3 months past the patient’s initial treatment. A total of 80 of 196 women (41%) randomized to perform a home test were rescreened, compared with 43 of 208 women (21%) randomized to a follow-up clinic visit. The difference was statistically significant.

Women in the take-home group also were significantly more likely to be rescreened at any point during the study, compared with the clinic group (49% vs. 28%).

The women were recruited from Jackson, Miss., New Orleans, and St. Louis. The average age of the women was 21 years; 85% of the home test group and 88% of the clinic test group were black. The education levels were similar between the two groups. All study participants had previously tested positive for chlamydia.

When the researchers analyzed the findings by demographic factors, women in the at-home test group who had a high school eduction or less were significantly more likely to be rescreened than were similarly educated women in the clinic group. For women who had some college education, there was no significant difference in screening rates between the at-home test and clinic test groups.

At the rescreening visits, 93 specimens from home test patients and 55 from clinic test patients were tested. The percentage of positive tests upon rescreening was similar between the groups: 13% in the home group and 15% in the clinic group.

Overall, rescreening rates were almost twice as high in the at-home test group as in the clinic group, Dr. Xu said. In several study subgroups, rescreening rates were consistently higher among women who used home tests, compared with clinic tests, she added.

Home testing for chlamydia represents a new tool, "but not the magic bullet," Dr. Xu said. More research is needed to identify better ways to remind patients to get rescreened for chlamydia, and more support is needed for FDA-approved tests for home specimen collection, she said.

Additional data from this study were published online in the August issue of Obstetrics & Gynecology (2011 August;118:231-239 [doi: 10.1097/AOG.0b013e3182246a83]).

Dr. Xu said that she had no financial conflicts to disclose.

QUEBEC CITY – When screening women for gonorrhea and chlamydia, screen them for Trichomonas vaginalis, too.

If left untreated, T. vaginalis (TV) can increase a woman’s risk for acquiring HIV from a sexual partner, or transmitting HIV to a sexual partner, according to the Centers for Disease Control and Prevention.

To determine the rates of coinfection for TV in women who are being screened for other STDs, Christine C. Ginocchio, Ph.D., of North Shore–Long Island Jewish Health System Laboratories in Lake Success, N.Y., and her colleagues collected samples from 7,593 women aged 18-89 years who were undergoing routine screening for chlamydia and gonorrhea. In all, 7,590 results were obtained from 30 labs in 21 states.

Overall, the prevalence of TV was 8.7%, compared with 6.7% for chlamydia and 1.7% for gonorrhea. TV was the most common of the three infections among women aged 30-39 years (8%), 40-49 years (11%), and 50 years and older (13%). The median age of the women who were positive for TV was slightly older (26 years), compared with that of the women who were positive for chlamydia and gonorrhea (22 years), according to the findings presented at a congress of the International Society for Sexually Transmitted Diseases Research.

The prevalence of TV (8.5%) fell between that of chlamydia (14%) and gonorrhea (3.3%) in women aged 18-19 years, and was 8.3% in women aged 20- 29 years, compared with 8% for chlamydia and 2% for gonorrhea.

The prevalence of TV as a coinfection with chlamydia and/or gonorrhea was relatively low across all age groups, but it occurred most often in younger women. TV and chlamydia coinfection occurred in approximately 2% of women aged 18-19 years. Other TV coinfections occurred in 1% or fewer of any age group.

When data were broken down by race, the prevalence of all three infections was greatest among black women. TV was the most prevalent (20%), compared with chlamydia (12%) and gonorrhea (4%) in these women. The prevalence of TV in other races was 11% in American Indians/Alaskan Natives, 7% in Native Hawaiians/Pacific Islanders, 6% in whites, 5% in Hispanics, 4% in Asians, and 7% in other or unknown races.

The women were seen in a range of settings including family practices, emergency departments, hospital inpatient settings, STD clinics, and jails. Prevalence data based on collection site showed that the prevalence of TV was highest in jail settings (22%) and emergency departments (17%). TV was the most common infection in all but family practice and internal medicine settings, where the prevalence was approximately 6%, compared with 7% for gonorrhea and 2% for chlamydia.

The findings support data from previous studies and indicate that the prevalence of TV varies widely based on the population being studied. The findings also support data from previous studies of racial disparity in TV.

However, "the high TV prevalence in all age groups suggests that all women being screened for chlamydia and gonorrhea should also be screened for TV," Dr. Ginocchio said.

Dr. Ginocchio said that she had no financial conflicts to disclose.

QUEBEC CITY – When screening women for gonorrhea and chlamydia, screen them for Trichomonas vaginalis, too.

If left untreated, T. vaginalis (TV) can increase a woman’s risk for acquiring HIV from a sexual partner, or transmitting HIV to a sexual partner, according to the Centers for Disease Control and Prevention.

To determine the rates of coinfection for TV in women who are being screened for other STDs, Christine C. Ginocchio, Ph.D., of North Shore–Long Island Jewish Health System Laboratories in Lake Success, N.Y., and her colleagues collected samples from 7,593 women aged 18-89 years who were undergoing routine screening for chlamydia and gonorrhea. In all, 7,590 results were obtained from 30 labs in 21 states.

Overall, the prevalence of TV was 8.7%, compared with 6.7% for chlamydia and 1.7% for gonorrhea. TV was the most common of the three infections among women aged 30-39 years (8%), 40-49 years (11%), and 50 years and older (13%). The median age of the women who were positive for TV was slightly older (26 years), compared with that of the women who were positive for chlamydia and gonorrhea (22 years), according to the findings presented at a congress of the International Society for Sexually Transmitted Diseases Research.

The prevalence of TV (8.5%) fell between that of chlamydia (14%) and gonorrhea (3.3%) in women aged 18-19 years, and was 8.3% in women aged 20- 29 years, compared with 8% for chlamydia and 2% for gonorrhea.

The prevalence of TV as a coinfection with chlamydia and/or gonorrhea was relatively low across all age groups, but it occurred most often in younger women. TV and chlamydia coinfection occurred in approximately 2% of women aged 18-19 years. Other TV coinfections occurred in 1% or fewer of any age group.

When data were broken down by race, the prevalence of all three infections was greatest among black women. TV was the most prevalent (20%), compared with chlamydia (12%) and gonorrhea (4%) in these women. The prevalence of TV in other races was 11% in American Indians/Alaskan Natives, 7% in Native Hawaiians/Pacific Islanders, 6% in whites, 5% in Hispanics, 4% in Asians, and 7% in other or unknown races.

The women were seen in a range of settings including family practices, emergency departments, hospital inpatient settings, STD clinics, and jails. Prevalence data based on collection site showed that the prevalence of TV was highest in jail settings (22%) and emergency departments (17%). TV was the most common infection in all but family practice and internal medicine settings, where the prevalence was approximately 6%, compared with 7% for gonorrhea and 2% for chlamydia.

The findings support data from previous studies and indicate that the prevalence of TV varies widely based on the population being studied. The findings also support data from previous studies of racial disparity in TV.

However, "the high TV prevalence in all age groups suggests that all women being screened for chlamydia and gonorrhea should also be screened for TV," Dr. Ginocchio said.

Dr. Ginocchio said that she had no financial conflicts to disclose.

QUEBEC CITY – When screening women for gonorrhea and chlamydia, screen them for Trichomonas vaginalis, too.

If left untreated, T. vaginalis (TV) can increase a woman’s risk for acquiring HIV from a sexual partner, or transmitting HIV to a sexual partner, according to the Centers for Disease Control and Prevention.

To determine the rates of coinfection for TV in women who are being screened for other STDs, Christine C. Ginocchio, Ph.D., of North Shore–Long Island Jewish Health System Laboratories in Lake Success, N.Y., and her colleagues collected samples from 7,593 women aged 18-89 years who were undergoing routine screening for chlamydia and gonorrhea. In all, 7,590 results were obtained from 30 labs in 21 states.

Overall, the prevalence of TV was 8.7%, compared with 6.7% for chlamydia and 1.7% for gonorrhea. TV was the most common of the three infections among women aged 30-39 years (8%), 40-49 years (11%), and 50 years and older (13%). The median age of the women who were positive for TV was slightly older (26 years), compared with that of the women who were positive for chlamydia and gonorrhea (22 years), according to the findings presented at a congress of the International Society for Sexually Transmitted Diseases Research.

The prevalence of TV (8.5%) fell between that of chlamydia (14%) and gonorrhea (3.3%) in women aged 18-19 years, and was 8.3% in women aged 20- 29 years, compared with 8% for chlamydia and 2% for gonorrhea.

The prevalence of TV as a coinfection with chlamydia and/or gonorrhea was relatively low across all age groups, but it occurred most often in younger women. TV and chlamydia coinfection occurred in approximately 2% of women aged 18-19 years. Other TV coinfections occurred in 1% or fewer of any age group.

When data were broken down by race, the prevalence of all three infections was greatest among black women. TV was the most prevalent (20%), compared with chlamydia (12%) and gonorrhea (4%) in these women. The prevalence of TV in other races was 11% in American Indians/Alaskan Natives, 7% in Native Hawaiians/Pacific Islanders, 6% in whites, 5% in Hispanics, 4% in Asians, and 7% in other or unknown races.

The women were seen in a range of settings including family practices, emergency departments, hospital inpatient settings, STD clinics, and jails. Prevalence data based on collection site showed that the prevalence of TV was highest in jail settings (22%) and emergency departments (17%). TV was the most common infection in all but family practice and internal medicine settings, where the prevalence was approximately 6%, compared with 7% for gonorrhea and 2% for chlamydia.

The findings support data from previous studies and indicate that the prevalence of TV varies widely based on the population being studied. The findings also support data from previous studies of racial disparity in TV.

However, "the high TV prevalence in all age groups suggests that all women being screened for chlamydia and gonorrhea should also be screened for TV," Dr. Ginocchio said.

Dr. Ginocchio said that she had no financial conflicts to disclose.

QUEBEC CITY – Be sure to screen men who have sex with men for gonorrhea, and don’t ignore the rectum, based on data from 1,076 MSM.

"Rectal gonorrhea probably predisposes individuals to HIV infection," said Dr. Marcus Chen of the University of Melbourne.

Gonorrhea infection of the pharynx and rectum is usually asymptomatic, but data show that these areas can be reservoirs of infection that can be transmitted during oral or anal sex, Dr. Chen said.

Understanding the natural history and transmissibility of the infection may help control the spread of gonorrhea in MSM, but data on the transmissibility of gonorrhea from the pharynx and rectum are limited, said Dr. Chen, who presented the data at the congress of the International Society for Sexually Transmitted Diseases Research.

In this study, Dr. Chen and his colleagues identified the gonococcal bacterial loads at the pharynx and rectum.

The study population included 1,076 consecutive MSM who were tested for gonorrhea at a single health center between January 2010 and April 2010. The mean age of the study population was 32 years.

Rectal and pharyngeal swabs were taken from each patient, and the samples were testing using both culture and polymerase chain reaction (PCR). A total of 1,011 rectal samples and 1,076 pharyngeal samples were analyzed.

Overall, the prevalence of pharyngeal gonorrhea was 4%, the prevalence of rectal gonorrhea was 5%, and the prevalence of gonorrhea in both locations was 1%. There were no symptomatic pharyngeal infections, but the prevalence of symptomatic rectal infections was 16%.

The bacterial loads were significantly higher in rectal infections, compared with pharyngeal (18,960 vs. 2,100 copies per swab), and higher in symptomatic rectal infections, compared with asymptomatic samples (278,800 vs. 13,980 copies per swab), Dr. Chen noted.

The sensitivity of the gonorrhea culture, compared with PCR, was 39% with a specificity of 53%, Dr. Chen noted. Consequently, bacterial loads were significantly higher in the positive cultures, compared with the negative cultures, for both types of gonorrhea.

The study is the first to compare the bacterial loads of gonorrhea in the pharynx and the rectum, Dr. Chen said. "Lower bacterial loads in the pharynx, compared with the rectum, point to possible lower transmission risk," he said. But more research is needed, including prospective studies to quantify the transmission of gonorrhea between MSM partners, he added.

Findings from additional studies could help doctors design more effective ways to screen for and control gonorrhea in the MSM population, Dr. Chen said.

Dr. Chen said that he had no financial conflicts to disclose.

QUEBEC CITY – Be sure to screen men who have sex with men for gonorrhea, and don’t ignore the rectum, based on data from 1,076 MSM.

"Rectal gonorrhea probably predisposes individuals to HIV infection," said Dr. Marcus Chen of the University of Melbourne.

Gonorrhea infection of the pharynx and rectum is usually asymptomatic, but data show that these areas can be reservoirs of infection that can be transmitted during oral or anal sex, Dr. Chen said.

Understanding the natural history and transmissibility of the infection may help control the spread of gonorrhea in MSM, but data on the transmissibility of gonorrhea from the pharynx and rectum are limited, said Dr. Chen, who presented the data at the congress of the International Society for Sexually Transmitted Diseases Research.

In this study, Dr. Chen and his colleagues identified the gonococcal bacterial loads at the pharynx and rectum.

The study population included 1,076 consecutive MSM who were tested for gonorrhea at a single health center between January 2010 and April 2010. The mean age of the study population was 32 years.

Rectal and pharyngeal swabs were taken from each patient, and the samples were testing using both culture and polymerase chain reaction (PCR). A total of 1,011 rectal samples and 1,076 pharyngeal samples were analyzed.

Overall, the prevalence of pharyngeal gonorrhea was 4%, the prevalence of rectal gonorrhea was 5%, and the prevalence of gonorrhea in both locations was 1%. There were no symptomatic pharyngeal infections, but the prevalence of symptomatic rectal infections was 16%.

The bacterial loads were significantly higher in rectal infections, compared with pharyngeal (18,960 vs. 2,100 copies per swab), and higher in symptomatic rectal infections, compared with asymptomatic samples (278,800 vs. 13,980 copies per swab), Dr. Chen noted.

The sensitivity of the gonorrhea culture, compared with PCR, was 39% with a specificity of 53%, Dr. Chen noted. Consequently, bacterial loads were significantly higher in the positive cultures, compared with the negative cultures, for both types of gonorrhea.

The study is the first to compare the bacterial loads of gonorrhea in the pharynx and the rectum, Dr. Chen said. "Lower bacterial loads in the pharynx, compared with the rectum, point to possible lower transmission risk," he said. But more research is needed, including prospective studies to quantify the transmission of gonorrhea between MSM partners, he added.

Findings from additional studies could help doctors design more effective ways to screen for and control gonorrhea in the MSM population, Dr. Chen said.

Dr. Chen said that he had no financial conflicts to disclose.

QUEBEC CITY – Be sure to screen men who have sex with men for gonorrhea, and don’t ignore the rectum, based on data from 1,076 MSM.

"Rectal gonorrhea probably predisposes individuals to HIV infection," said Dr. Marcus Chen of the University of Melbourne.

Gonorrhea infection of the pharynx and rectum is usually asymptomatic, but data show that these areas can be reservoirs of infection that can be transmitted during oral or anal sex, Dr. Chen said.

Understanding the natural history and transmissibility of the infection may help control the spread of gonorrhea in MSM, but data on the transmissibility of gonorrhea from the pharynx and rectum are limited, said Dr. Chen, who presented the data at the congress of the International Society for Sexually Transmitted Diseases Research.

In this study, Dr. Chen and his colleagues identified the gonococcal bacterial loads at the pharynx and rectum.

The study population included 1,076 consecutive MSM who were tested for gonorrhea at a single health center between January 2010 and April 2010. The mean age of the study population was 32 years.

Rectal and pharyngeal swabs were taken from each patient, and the samples were testing using both culture and polymerase chain reaction (PCR). A total of 1,011 rectal samples and 1,076 pharyngeal samples were analyzed.

Overall, the prevalence of pharyngeal gonorrhea was 4%, the prevalence of rectal gonorrhea was 5%, and the prevalence of gonorrhea in both locations was 1%. There were no symptomatic pharyngeal infections, but the prevalence of symptomatic rectal infections was 16%.

The bacterial loads were significantly higher in rectal infections, compared with pharyngeal (18,960 vs. 2,100 copies per swab), and higher in symptomatic rectal infections, compared with asymptomatic samples (278,800 vs. 13,980 copies per swab), Dr. Chen noted.

The sensitivity of the gonorrhea culture, compared with PCR, was 39% with a specificity of 53%, Dr. Chen noted. Consequently, bacterial loads were significantly higher in the positive cultures, compared with the negative cultures, for both types of gonorrhea.

The study is the first to compare the bacterial loads of gonorrhea in the pharynx and the rectum, Dr. Chen said. "Lower bacterial loads in the pharynx, compared with the rectum, point to possible lower transmission risk," he said. But more research is needed, including prospective studies to quantify the transmission of gonorrhea between MSM partners, he added.

Findings from additional studies could help doctors design more effective ways to screen for and control gonorrhea in the MSM population, Dr. Chen said.

Dr. Chen said that he had no financial conflicts to disclose.

QUEBEC CITY – Be sure to screen men who have sex with men for gonorrhea, and don’t ignore the rectum, based on data from 1,076 MSM.

"Rectal gonorrhea probably predisposes individuals to HIV infection," said Dr. Marcus Chen of the University of Melbourne.

Gonorrhea infection of the pharynx and rectum is usually asymptomatic, but data show that these areas can be reservoirs of infection that can be transmitted during oral or anal sex, Dr. Chen said.

Understanding the natural history and transmissibility of the infection may help control the spread of gonorrhea in MSM, but data on the transmissibility of gonorrhea from the pharynx and rectum are limited, said Dr. Chen, who presented the data at the congress of the International Society for Sexually Transmitted Diseases Research.

In this study, Dr. Chen and his colleagues identified the gonococcal bacterial loads at the pharynx and rectum.

The study population included 1,076 consecutive MSM who were tested for gonorrhea at a single health center between January 2010 and April 2010. The mean age of the study population was 32 years.

Rectal and pharyngeal swabs were taken from each patient, and the samples were testing using both culture and polymerase chain reaction (PCR). A total of 1,011 rectal samples and 1,076 pharyngeal samples were analyzed.

Overall, the prevalence of pharyngeal gonorrhea was 4%, the prevalence of rectal gonorrhea was 5%, and the prevalence of gonorrhea in both locations was 1%. There were no symptomatic pharyngeal infections, but the prevalence of symptomatic rectal infections was 16%.

The bacterial loads were significantly higher in rectal infections, compared with pharyngeal (18,960 vs. 2,100 copies per swab), and higher in symptomatic rectal infections, compared with asymptomatic samples (278,800 vs. 13,980 copies per swab), Dr. Chen noted.

The sensitivity of the gonorrhea culture, compared with PCR, was 39% with a specificity of 53%, Dr. Chen noted. Consequently, bacterial loads were significantly higher in the positive cultures, compared with the negative cultures, for both types of gonorrhea.

The study is the first to compare the bacterial loads of gonorrhea in the pharynx and the rectum, Dr. Chen said. "Lower bacterial loads in the pharynx, compared with the rectum, point to possible lower transmission risk," he said. But more research is needed, including prospective studies to quantify the transmission of gonorrhea between MSM partners, he added.

Findings from additional studies could help doctors design more effective ways to screen for and control gonorrhea in the MSM population, Dr. Chen said.

Dr. Chen said that he had no financial conflicts to disclose.

QUEBEC CITY – Be sure to screen men who have sex with men for gonorrhea, and don’t ignore the rectum, based on data from 1,076 MSM.

"Rectal gonorrhea probably predisposes individuals to HIV infection," said Dr. Marcus Chen of the University of Melbourne.

Gonorrhea infection of the pharynx and rectum is usually asymptomatic, but data show that these areas can be reservoirs of infection that can be transmitted during oral or anal sex, Dr. Chen said.

Understanding the natural history and transmissibility of the infection may help control the spread of gonorrhea in MSM, but data on the transmissibility of gonorrhea from the pharynx and rectum are limited, said Dr. Chen, who presented the data at the congress of the International Society for Sexually Transmitted Diseases Research.

In this study, Dr. Chen and his colleagues identified the gonococcal bacterial loads at the pharynx and rectum.

The study population included 1,076 consecutive MSM who were tested for gonorrhea at a single health center between January 2010 and April 2010. The mean age of the study population was 32 years.

Rectal and pharyngeal swabs were taken from each patient, and the samples were testing using both culture and polymerase chain reaction (PCR). A total of 1,011 rectal samples and 1,076 pharyngeal samples were analyzed.

Overall, the prevalence of pharyngeal gonorrhea was 4%, the prevalence of rectal gonorrhea was 5%, and the prevalence of gonorrhea in both locations was 1%. There were no symptomatic pharyngeal infections, but the prevalence of symptomatic rectal infections was 16%.

The bacterial loads were significantly higher in rectal infections, compared with pharyngeal (18,960 vs. 2,100 copies per swab), and higher in symptomatic rectal infections, compared with asymptomatic samples (278,800 vs. 13,980 copies per swab), Dr. Chen noted.

The sensitivity of the gonorrhea culture, compared with PCR, was 39% with a specificity of 53%, Dr. Chen noted. Consequently, bacterial loads were significantly higher in the positive cultures, compared with the negative cultures, for both types of gonorrhea.

The study is the first to compare the bacterial loads of gonorrhea in the pharynx and the rectum, Dr. Chen said. "Lower bacterial loads in the pharynx, compared with the rectum, point to possible lower transmission risk," he said. But more research is needed, including prospective studies to quantify the transmission of gonorrhea between MSM partners, he added.

Findings from additional studies could help doctors design more effective ways to screen for and control gonorrhea in the MSM population, Dr. Chen said.

Dr. Chen said that he had no financial conflicts to disclose.

QUEBEC CITY – Be sure to screen men who have sex with men for gonorrhea, and don’t ignore the rectum, based on data from 1,076 MSM.

"Rectal gonorrhea probably predisposes individuals to HIV infection," said Dr. Marcus Chen of the University of Melbourne.

Gonorrhea infection of the pharynx and rectum is usually asymptomatic, but data show that these areas can be reservoirs of infection that can be transmitted during oral or anal sex, Dr. Chen said.

Understanding the natural history and transmissibility of the infection may help control the spread of gonorrhea in MSM, but data on the transmissibility of gonorrhea from the pharynx and rectum are limited, said Dr. Chen, who presented the data at the congress of the International Society for Sexually Transmitted Diseases Research.

In this study, Dr. Chen and his colleagues identified the gonococcal bacterial loads at the pharynx and rectum.

The study population included 1,076 consecutive MSM who were tested for gonorrhea at a single health center between January 2010 and April 2010. The mean age of the study population was 32 years.

Rectal and pharyngeal swabs were taken from each patient, and the samples were testing using both culture and polymerase chain reaction (PCR). A total of 1,011 rectal samples and 1,076 pharyngeal samples were analyzed.

Overall, the prevalence of pharyngeal gonorrhea was 4%, the prevalence of rectal gonorrhea was 5%, and the prevalence of gonorrhea in both locations was 1%. There were no symptomatic pharyngeal infections, but the prevalence of symptomatic rectal infections was 16%.

The bacterial loads were significantly higher in rectal infections, compared with pharyngeal (18,960 vs. 2,100 copies per swab), and higher in symptomatic rectal infections, compared with asymptomatic samples (278,800 vs. 13,980 copies per swab), Dr. Chen noted.

The sensitivity of the gonorrhea culture, compared with PCR, was 39% with a specificity of 53%, Dr. Chen noted. Consequently, bacterial loads were significantly higher in the positive cultures, compared with the negative cultures, for both types of gonorrhea.

The study is the first to compare the bacterial loads of gonorrhea in the pharynx and the rectum, Dr. Chen said. "Lower bacterial loads in the pharynx, compared with the rectum, point to possible lower transmission risk," he said. But more research is needed, including prospective studies to quantify the transmission of gonorrhea between MSM partners, he added.

Findings from additional studies could help doctors design more effective ways to screen for and control gonorrhea in the MSM population, Dr. Chen said.

Dr. Chen said that he had no financial conflicts to disclose.

QUEBEC CITY  – Oral metronidazole was not more effective for bacterial vaginosis when combined with clindamycin or a probiotic, based on data from 450 women.

"Bacterial vaginosis is the most common cause of infections in women worldwide," said Dr. Catriona Bradshaw of the University of Melbourne. Current monotherapy treatments are not highly effective, and up to 50-60% of women have recurrent bacterial vaginosis (BV) after treatment. Dr. Bradshaw and her colleagues examined whether a combination of oral and vaginal therapy could be more effective.

Data on the efficacy of vaginal probiotics for BV are limited, said Dr. Bradshaw. But the growing awareness of and interest in probiotics helped drive the study, she said.

In this study, 150 women were randomized to each of three treatments: oral metronidazole plus vaginal clindamycin, oral metronidazole plus a vaginal probiotic, or oral metronidazole plus a placebo. The women ranged in age from 18 to 50 years, all had bacterial vaginosis, and none were HIV positive. There were no significant demographic or behavioral differences among the three groups. Dr. Bradshaw presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Overall, 382 (85%) of the women had baseline Nugent scores of 7-10 – which is considered highly positive for bacterial vaginosis – on a scale of 0-10.

In the intent-to-treat population, the cumulative 6-month BV recurrent rate was 28%. The hazard ratio for BV recurrence at 6 months posttreatment was 1.09 for the clindamycin group and 1.03 for the probiotic group, compared with 1.00 for the placebo group.

The cumulative 6-month recurrence rate for abnormal vaginal flora was 54%, and the hazard ratio for the recurrence of abnormal flora was 1.01 for the clindamycin group and 0.97 for the probiotic group, compared with 1.0 for the placebo group.

The self-reported adherence to vaginal therapy in the clindamycin, probiotic, and placebo groups was 88%, 77%, and 78%, respectively, and to oral metronidazole was more than 90% for all three study arms Dr. Bradshaw said.

The most common self-reported side effect was vaginal itching or soreness, reported by approximately one-third of the patients in each treatment group.

"The implications for clinicians are to keep an open mind about BV and to keep an eye on the literature to look for improved therapies," she said. Also, clinicians should inform patients about the limitations of current therapies. "A lot of women are quite disappointed when their BV comes back," she said.

Dr. Bradshaw said that she had no financial conflicts to disclose.

QUEBEC CITY  – Oral metronidazole was not more effective for bacterial vaginosis when combined with clindamycin or a probiotic, based on data from 450 women.

"Bacterial vaginosis is the most common cause of infections in women worldwide," said Dr. Catriona Bradshaw of the University of Melbourne. Current monotherapy treatments are not highly effective, and up to 50-60% of women have recurrent bacterial vaginosis (BV) after treatment. Dr. Bradshaw and her colleagues examined whether a combination of oral and vaginal therapy could be more effective.

Data on the efficacy of vaginal probiotics for BV are limited, said Dr. Bradshaw. But the growing awareness of and interest in probiotics helped drive the study, she said.

In this study, 150 women were randomized to each of three treatments: oral metronidazole plus vaginal clindamycin, oral metronidazole plus a vaginal probiotic, or oral metronidazole plus a placebo. The women ranged in age from 18 to 50 years, all had bacterial vaginosis, and none were HIV positive. There were no significant demographic or behavioral differences among the three groups. Dr. Bradshaw presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Overall, 382 (85%) of the women had baseline Nugent scores of 7-10 – which is considered highly positive for bacterial vaginosis – on a scale of 0-10.

In the intent-to-treat population, the cumulative 6-month BV recurrent rate was 28%. The hazard ratio for BV recurrence at 6 months posttreatment was 1.09 for the clindamycin group and 1.03 for the probiotic group, compared with 1.00 for the placebo group.

The cumulative 6-month recurrence rate for abnormal vaginal flora was 54%, and the hazard ratio for the recurrence of abnormal flora was 1.01 for the clindamycin group and 0.97 for the probiotic group, compared with 1.0 for the placebo group.

The self-reported adherence to vaginal therapy in the clindamycin, probiotic, and placebo groups was 88%, 77%, and 78%, respectively, and to oral metronidazole was more than 90% for all three study arms Dr. Bradshaw said.

The most common self-reported side effect was vaginal itching or soreness, reported by approximately one-third of the patients in each treatment group.

"The implications for clinicians are to keep an open mind about BV and to keep an eye on the literature to look for improved therapies," she said. Also, clinicians should inform patients about the limitations of current therapies. "A lot of women are quite disappointed when their BV comes back," she said.

Dr. Bradshaw said that she had no financial conflicts to disclose.

QUEBEC CITY  – Oral metronidazole was not more effective for bacterial vaginosis when combined with clindamycin or a probiotic, based on data from 450 women.

"Bacterial vaginosis is the most common cause of infections in women worldwide," said Dr. Catriona Bradshaw of the University of Melbourne. Current monotherapy treatments are not highly effective, and up to 50-60% of women have recurrent bacterial vaginosis (BV) after treatment. Dr. Bradshaw and her colleagues examined whether a combination of oral and vaginal therapy could be more effective.

Data on the efficacy of vaginal probiotics for BV are limited, said Dr. Bradshaw. But the growing awareness of and interest in probiotics helped drive the study, she said.

In this study, 150 women were randomized to each of three treatments: oral metronidazole plus vaginal clindamycin, oral metronidazole plus a vaginal probiotic, or oral metronidazole plus a placebo. The women ranged in age from 18 to 50 years, all had bacterial vaginosis, and none were HIV positive. There were no significant demographic or behavioral differences among the three groups. Dr. Bradshaw presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Overall, 382 (85%) of the women had baseline Nugent scores of 7-10 – which is considered highly positive for bacterial vaginosis – on a scale of 0-10.

In the intent-to-treat population, the cumulative 6-month BV recurrent rate was 28%. The hazard ratio for BV recurrence at 6 months posttreatment was 1.09 for the clindamycin group and 1.03 for the probiotic group, compared with 1.00 for the placebo group.

The cumulative 6-month recurrence rate for abnormal vaginal flora was 54%, and the hazard ratio for the recurrence of abnormal flora was 1.01 for the clindamycin group and 0.97 for the probiotic group, compared with 1.0 for the placebo group.

The self-reported adherence to vaginal therapy in the clindamycin, probiotic, and placebo groups was 88%, 77%, and 78%, respectively, and to oral metronidazole was more than 90% for all three study arms Dr. Bradshaw said.

The most common self-reported side effect was vaginal itching or soreness, reported by approximately one-third of the patients in each treatment group.

"The implications for clinicians are to keep an open mind about BV and to keep an eye on the literature to look for improved therapies," she said. Also, clinicians should inform patients about the limitations of current therapies. "A lot of women are quite disappointed when their BV comes back," she said.

Dr. Bradshaw said that she had no financial conflicts to disclose.

QUEBEC CITY – Oral metronidazole was not more effective for bacterial vaginosis when combined with clindamycin or a probiotic, based on data from 450 women.

"Bacterial vaginosis is the most common cause of infections in women worldwide," said Dr. Catriona Bradshaw of the University of Melbourne. Current monotherapy treatments are not highly effective, and up to 50-60% of women have recurrent bacterial vaginosis (BV) after treatment. Dr. Bradshaw and her colleagues examined whether a combination of oral and vaginal therapy could be more effective.

Data on the efficacy of vaginal probiotics for BV are limited, said Dr. Bradshaw. But the growing awareness of and interest in probiotics helped drive the study, she said.

In this study, 150 women were randomized to each of three treatments: oral metronidazole plus vaginal clindamycin, oral metronidazole plus a vaginal probiotic, or oral metronidazole plus a placebo. The women ranged in age from 18 to 50 years, all had bacterial vaginosis, and none were HIV positive. There were no significant demographic or behavioral differences among the three groups. Dr. Bradshaw presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Overall, 382 (85%) of the women had baseline Nugent scores of 7-10 – which is considered highly positive for bacterial vaginosis – on a scale of 0-10.

In the intent-to-treat population, the cumulative 6-month BV recurrent rate was 28%. The hazard ratio for BV recurrence at 6 months posttreatment was 1.09 for the clindamycin group and 1.03 for the probiotic group, compared with 1.00 for the placebo group.

The cumulative 6-month recurrence rate for abnormal vaginal flora was 54%, and the hazard ratio for the recurrence of abnormal flora was 1.01 for the clindamycin group and 0.97 for the probiotic group, compared with 1.0 for the placebo group.

The self-reported adherence to vaginal therapy in the clindamycin, probiotic, and placebo groups was 88%, 77%, and 78%, respectively, and to oral metronidazole was more than 90% for all three study arms Dr. Bradshaw said.

The most common self-reported side effect was vaginal itching or soreness, reported by approximately one-third of the patients in each treatment group.

"The implications for clinicians are to keep an open mind about BV and to keep an eye on the literature to look for improved therapies," she said. Also, clinicians should inform patients about the limitations of current therapies. "A lot of women are quite disappointed when their BV comes back," she said.

Dr. Bradshaw said that she had no financial conflicts to disclose.

QUEBEC CITY – Oral metronidazole was not more effective for bacterial vaginosis when combined with clindamycin or a probiotic, based on data from 450 women.

"Bacterial vaginosis is the most common cause of infections in women worldwide," said Dr. Catriona Bradshaw of the University of Melbourne. Current monotherapy treatments are not highly effective, and up to 50-60% of women have recurrent bacterial vaginosis (BV) after treatment. Dr. Bradshaw and her colleagues examined whether a combination of oral and vaginal therapy could be more effective.

Data on the efficacy of vaginal probiotics for BV are limited, said Dr. Bradshaw. But the growing awareness of and interest in probiotics helped drive the study, she said.

In this study, 150 women were randomized to each of three treatments: oral metronidazole plus vaginal clindamycin, oral metronidazole plus a vaginal probiotic, or oral metronidazole plus a placebo. The women ranged in age from 18 to 50 years, all had bacterial vaginosis, and none were HIV positive. There were no significant demographic or behavioral differences among the three groups. Dr. Bradshaw presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Overall, 382 (85%) of the women had baseline Nugent scores of 7-10 – which is considered highly positive for bacterial vaginosis – on a scale of 0-10.

In the intent-to-treat population, the cumulative 6-month BV recurrent rate was 28%. The hazard ratio for BV recurrence at 6 months posttreatment was 1.09 for the clindamycin group and 1.03 for the probiotic group, compared with 1.00 for the placebo group.

The cumulative 6-month recurrence rate for abnormal vaginal flora was 54%, and the hazard ratio for the recurrence of abnormal flora was 1.01 for the clindamycin group and 0.97 for the probiotic group, compared with 1.0 for the placebo group.

The self-reported adherence to vaginal therapy in the clindamycin, probiotic, and placebo groups was 88%, 77%, and 78%, respectively, and to oral metronidazole was more than 90% for all three study arms Dr. Bradshaw said.

The most common self-reported side effect was vaginal itching or soreness, reported by approximately one-third of the patients in each treatment group.

"The implications for clinicians are to keep an open mind about BV and to keep an eye on the literature to look for improved therapies," she said. Also, clinicians should inform patients about the limitations of current therapies. "A lot of women are quite disappointed when their BV comes back," she said.

Dr. Bradshaw said that she had no financial conflicts to disclose.

QUEBEC CITY – Oral metronidazole was not more effective for bacterial vaginosis when combined with clindamycin or a probiotic, based on data from 450 women.

"Bacterial vaginosis is the most common cause of infections in women worldwide," said Dr. Catriona Bradshaw of the University of Melbourne. Current monotherapy treatments are not highly effective, and up to 50-60% of women have recurrent bacterial vaginosis (BV) after treatment. Dr. Bradshaw and her colleagues examined whether a combination of oral and vaginal therapy could be more effective.

Data on the efficacy of vaginal probiotics for BV are limited, said Dr. Bradshaw. But the growing awareness of and interest in probiotics helped drive the study, she said.

In this study, 150 women were randomized to each of three treatments: oral metronidazole plus vaginal clindamycin, oral metronidazole plus a vaginal probiotic, or oral metronidazole plus a placebo. The women ranged in age from 18 to 50 years, all had bacterial vaginosis, and none were HIV positive. There were no significant demographic or behavioral differences among the three groups. Dr. Bradshaw presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Overall, 382 (85%) of the women had baseline Nugent scores of 7-10 – which is considered highly positive for bacterial vaginosis – on a scale of 0-10.

In the intent-to-treat population, the cumulative 6-month BV recurrent rate was 28%. The hazard ratio for BV recurrence at 6 months posttreatment was 1.09 for the clindamycin group and 1.03 for the probiotic group, compared with 1.00 for the placebo group.

The cumulative 6-month recurrence rate for abnormal vaginal flora was 54%, and the hazard ratio for the recurrence of abnormal flora was 1.01 for the clindamycin group and 0.97 for the probiotic group, compared with 1.0 for the placebo group.

The self-reported adherence to vaginal therapy in the clindamycin, probiotic, and placebo groups was 88%, 77%, and 78%, respectively, and to oral metronidazole was more than 90% for all three study arms Dr. Bradshaw said.

The most common self-reported side effect was vaginal itching or soreness, reported by approximately one-third of the patients in each treatment group.

"The implications for clinicians are to keep an open mind about BV and to keep an eye on the literature to look for improved therapies," she said. Also, clinicians should inform patients about the limitations of current therapies. "A lot of women are quite disappointed when their BV comes back," she said.

Dr. Bradshaw said that she had no financial conflicts to disclose.

QUEBEC CITY – Men who have sex with men can self-test for chlamydia and gonorrhea as effectively as health care providers can, according to findings from a study involving 286 adult men.

Data from previous studies show that the risk of HIV infection increases in men who have sex with men (MSM) who have other sexually transmitted diseases, said Dr. Marybeth Sexton of Columbia University, New York. Therefore, regular STD testing for MSM is important, however "less than 14% of physicians routinely screen male patients for chlamydia and gonorrhea," Dr. Sexton said at a congress of the International Society for Sexually Transmitted Diseases Research. Lack of time, lack of staff, and lack of knowledge were the reasons most often given for not screening.

In this study, Dr. Sexton and colleagues in Washington, D.C. compared the results of nucleic acid amplification testing (NAAT) for chlamydia and gonorrhea when MSM administered the tests themselves and when a health care provider administered the tests.

Patients were recruited from the Whitman-Walker Clinic in Washington, and they were eligible for the study if they reported having intercourse with a man within the past 6 months and if they wanted to be screened for rectal and pharyngeal chlamydia and gonorrhea.

The screening tests were performed twice on each patient, and the patients were randomized to initially perform self-tests or to be tested by a health care provider. For the self-test, patients were given instructional cards, and a health care provider was present, but offered no additional assistance.

Overall, both providers and patients had positive test results for 12 cases of rectal gonorrhea, 15 cases of pharyngeal gonorrhea, 25 cases of rectal chlamydia, and 3 cases of pharyngeal chlamydia. Both providers and patients had negative results for rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia in 193, 256, 183, and 277 tests, respectively.

The only time a provider’s test was positive and a patient’s test was negative was a single case of pharyngeal gonorrhea. However, patients’ tests were positive when providers’ tests were negative in six cases of rectal gonorrhea, nine cases of pharyngeal gonorrhea, three cases of rectal chlamydia, and two cases of pharyngeal chlamydia.

The prevalence of rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia using only the provider’s positive tests was 5.7%, 5.7%, 12%, and 1.1%. The prevalence using both the patients’ and providers’ positive results was 8.5%, 8.9%, 13.3%, and 1.8%, respectively.

There were no significant differences in the detection of gonorrhea between the patients and providers, Dr. Sexton said. Patients appeared to identify significantly more cases of gonorrhea, which might be due to false positives, cross-contamination, or more rigorous testing on the part of the patient, she noted.

Test results were no different based on whether the patient or the health care provider collected samples first.

Self-administered STD tests could reduce the time burden on health care providers and expand the number of MSM who are tested, said Dr. Sexton. In addition, informal feedback from patients suggested that, for the most part, the tests were easy to perform and more acceptable than allowing a health care provider to collect the samples.

"I talked to a lot of the patients, and many of them said they would prefer to do the testing on their own," Dr. Sexton said.

The results suggest that self-testing is a feasible option. However, some modifications need to be made to the testing instructions, and more research is needed to determine the best way to incorporate self-testing into a clinical setting, she noted.

Dr. Sexton had no financial conflicts to disclose. Test kits used in the study were provided by Gen-Probe.

QUEBEC CITY – Men who have sex with men can self-test for chlamydia and gonorrhea as effectively as health care providers can, according to findings from a study involving 286 adult men.

Data from previous studies show that the risk of HIV infection increases in men who have sex with men (MSM) who have other sexually transmitted diseases, said Dr. Marybeth Sexton of Columbia University, New York. Therefore, regular STD testing for MSM is important, however "less than 14% of physicians routinely screen male patients for chlamydia and gonorrhea," Dr. Sexton said at a congress of the International Society for Sexually Transmitted Diseases Research. Lack of time, lack of staff, and lack of knowledge were the reasons most often given for not screening.

In this study, Dr. Sexton and colleagues in Washington, D.C. compared the results of nucleic acid amplification testing (NAAT) for chlamydia and gonorrhea when MSM administered the tests themselves and when a health care provider administered the tests.

Patients were recruited from the Whitman-Walker Clinic in Washington, and they were eligible for the study if they reported having intercourse with a man within the past 6 months and if they wanted to be screened for rectal and pharyngeal chlamydia and gonorrhea.

The screening tests were performed twice on each patient, and the patients were randomized to initially perform self-tests or to be tested by a health care provider. For the self-test, patients were given instructional cards, and a health care provider was present, but offered no additional assistance.

Overall, both providers and patients had positive test results for 12 cases of rectal gonorrhea, 15 cases of pharyngeal gonorrhea, 25 cases of rectal chlamydia, and 3 cases of pharyngeal chlamydia. Both providers and patients had negative results for rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia in 193, 256, 183, and 277 tests, respectively.

The only time a provider’s test was positive and a patient’s test was negative was a single case of pharyngeal gonorrhea. However, patients’ tests were positive when providers’ tests were negative in six cases of rectal gonorrhea, nine cases of pharyngeal gonorrhea, three cases of rectal chlamydia, and two cases of pharyngeal chlamydia.

The prevalence of rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia using only the provider’s positive tests was 5.7%, 5.7%, 12%, and 1.1%. The prevalence using both the patients’ and providers’ positive results was 8.5%, 8.9%, 13.3%, and 1.8%, respectively.

There were no significant differences in the detection of gonorrhea between the patients and providers, Dr. Sexton said. Patients appeared to identify significantly more cases of gonorrhea, which might be due to false positives, cross-contamination, or more rigorous testing on the part of the patient, she noted.

Test results were no different based on whether the patient or the health care provider collected samples first.

Self-administered STD tests could reduce the time burden on health care providers and expand the number of MSM who are tested, said Dr. Sexton. In addition, informal feedback from patients suggested that, for the most part, the tests were easy to perform and more acceptable than allowing a health care provider to collect the samples.

"I talked to a lot of the patients, and many of them said they would prefer to do the testing on their own," Dr. Sexton said.

The results suggest that self-testing is a feasible option. However, some modifications need to be made to the testing instructions, and more research is needed to determine the best way to incorporate self-testing into a clinical setting, she noted.

Dr. Sexton had no financial conflicts to disclose. Test kits used in the study were provided by Gen-Probe.

QUEBEC CITY – Men who have sex with men can self-test for chlamydia and gonorrhea as effectively as health care providers can, according to findings from a study involving 286 adult men.

Data from previous studies show that the risk of HIV infection increases in men who have sex with men (MSM) who have other sexually transmitted diseases, said Dr. Marybeth Sexton of Columbia University, New York. Therefore, regular STD testing for MSM is important, however "less than 14% of physicians routinely screen male patients for chlamydia and gonorrhea," Dr. Sexton said at a congress of the International Society for Sexually Transmitted Diseases Research. Lack of time, lack of staff, and lack of knowledge were the reasons most often given for not screening.

In this study, Dr. Sexton and colleagues in Washington, D.C. compared the results of nucleic acid amplification testing (NAAT) for chlamydia and gonorrhea when MSM administered the tests themselves and when a health care provider administered the tests.

Patients were recruited from the Whitman-Walker Clinic in Washington, and they were eligible for the study if they reported having intercourse with a man within the past 6 months and if they wanted to be screened for rectal and pharyngeal chlamydia and gonorrhea.

The screening tests were performed twice on each patient, and the patients were randomized to initially perform self-tests or to be tested by a health care provider. For the self-test, patients were given instructional cards, and a health care provider was present, but offered no additional assistance.

Overall, both providers and patients had positive test results for 12 cases of rectal gonorrhea, 15 cases of pharyngeal gonorrhea, 25 cases of rectal chlamydia, and 3 cases of pharyngeal chlamydia. Both providers and patients had negative results for rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia in 193, 256, 183, and 277 tests, respectively.

The only time a provider’s test was positive and a patient’s test was negative was a single case of pharyngeal gonorrhea. However, patients’ tests were positive when providers’ tests were negative in six cases of rectal gonorrhea, nine cases of pharyngeal gonorrhea, three cases of rectal chlamydia, and two cases of pharyngeal chlamydia.

The prevalence of rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia using only the provider’s positive tests was 5.7%, 5.7%, 12%, and 1.1%. The prevalence using both the patients’ and providers’ positive results was 8.5%, 8.9%, 13.3%, and 1.8%, respectively.

There were no significant differences in the detection of gonorrhea between the patients and providers, Dr. Sexton said. Patients appeared to identify significantly more cases of gonorrhea, which might be due to false positives, cross-contamination, or more rigorous testing on the part of the patient, she noted.

Test results were no different based on whether the patient or the health care provider collected samples first.

Self-administered STD tests could reduce the time burden on health care providers and expand the number of MSM who are tested, said Dr. Sexton. In addition, informal feedback from patients suggested that, for the most part, the tests were easy to perform and more acceptable than allowing a health care provider to collect the samples.

"I talked to a lot of the patients, and many of them said they would prefer to do the testing on their own," Dr. Sexton said.

The results suggest that self-testing is a feasible option. However, some modifications need to be made to the testing instructions, and more research is needed to determine the best way to incorporate self-testing into a clinical setting, she noted.

Dr. Sexton had no financial conflicts to disclose. Test kits used in the study were provided by Gen-Probe.

QUEBEC CITY – Men who have sex with men can self-test for chlamydia and gonorrhea as effectively as health care providers can, according to findings from a study involving 286 adult men.

Data from previous studies show that the risk of HIV infection increases in men who have sex with men (MSM) who have other sexually transmitted diseases, said Dr. Marybeth Sexton of Columbia University, New York. Therefore, regular STD testing for MSM is important, however "less than 14% of physicians routinely screen male patients for chlamydia and gonorrhea," Dr. Sexton said at a congress of the International Society for Sexually Transmitted Diseases Research. Lack of time, lack of staff, and lack of knowledge were the reasons most often given for not screening.

In this study, Dr. Sexton and colleagues in Washington, D.C. compared the results of nucleic acid amplification testing (NAAT) for chlamydia and gonorrhea when MSM administered the tests themselves and when a health care provider administered the tests.

Patients were recruited from the Whitman-Walker Clinic in Washington, and they were eligible for the study if they reported having intercourse with a man within the past 6 months and if they wanted to be screened for rectal and pharyngeal chlamydia and gonorrhea.

The screening tests were performed twice on each patient, and the patients were randomized to initially perform self-tests or to be tested by a health care provider. For the self-test, patients were given instructional cards, and a health care provider was present, but offered no additional assistance.

Overall, both providers and patients had positive test results for 12 cases of rectal gonorrhea, 15 cases of pharyngeal gonorrhea, 25 cases of rectal chlamydia, and 3 cases of pharyngeal chlamydia. Both providers and patients had negative results for rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia in 193, 256, 183, and 277 tests, respectively.

The only time a provider’s test was positive and a patient’s test was negative was a single case of pharyngeal gonorrhea. However, patients’ tests were positive when providers’ tests were negative in six cases of rectal gonorrhea, nine cases of pharyngeal gonorrhea, three cases of rectal chlamydia, and two cases of pharyngeal chlamydia.

The prevalence of rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia using only the provider’s positive tests was 5.7%, 5.7%, 12%, and 1.1%. The prevalence using both the patients’ and providers’ positive results was 8.5%, 8.9%, 13.3%, and 1.8%, respectively.

There were no significant differences in the detection of gonorrhea between the patients and providers, Dr. Sexton said. Patients appeared to identify significantly more cases of gonorrhea, which might be due to false positives, cross-contamination, or more rigorous testing on the part of the patient, she noted.

Test results were no different based on whether the patient or the health care provider collected samples first.

Self-administered STD tests could reduce the time burden on health care providers and expand the number of MSM who are tested, said Dr. Sexton. In addition, informal feedback from patients suggested that, for the most part, the tests were easy to perform and more acceptable than allowing a health care provider to collect the samples.

"I talked to a lot of the patients, and many of them said they would prefer to do the testing on their own," Dr. Sexton said.

The results suggest that self-testing is a feasible option. However, some modifications need to be made to the testing instructions, and more research is needed to determine the best way to incorporate self-testing into a clinical setting, she noted.

Dr. Sexton had no financial conflicts to disclose. Test kits used in the study were provided by Gen-Probe.

QUEBEC CITY – Men who have sex with men can self-test for chlamydia and gonorrhea as effectively as health care providers can, according to findings from a study involving 286 adult men.

Data from previous studies show that the risk of HIV infection increases in men who have sex with men (MSM) who have other sexually transmitted diseases, said Dr. Marybeth Sexton of Columbia University, New York. Therefore, regular STD testing for MSM is important, however "less than 14% of physicians routinely screen male patients for chlamydia and gonorrhea," Dr. Sexton said at a congress of the International Society for Sexually Transmitted Diseases Research. Lack of time, lack of staff, and lack of knowledge were the reasons most often given for not screening.

In this study, Dr. Sexton and colleagues in Washington, D.C. compared the results of nucleic acid amplification testing (NAAT) for chlamydia and gonorrhea when MSM administered the tests themselves and when a health care provider administered the tests.

Patients were recruited from the Whitman-Walker Clinic in Washington, and they were eligible for the study if they reported having intercourse with a man within the past 6 months and if they wanted to be screened for rectal and pharyngeal chlamydia and gonorrhea.

The screening tests were performed twice on each patient, and the patients were randomized to initially perform self-tests or to be tested by a health care provider. For the self-test, patients were given instructional cards, and a health care provider was present, but offered no additional assistance.

Overall, both providers and patients had positive test results for 12 cases of rectal gonorrhea, 15 cases of pharyngeal gonorrhea, 25 cases of rectal chlamydia, and 3 cases of pharyngeal chlamydia. Both providers and patients had negative results for rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia in 193, 256, 183, and 277 tests, respectively.

The only time a provider’s test was positive and a patient’s test was negative was a single case of pharyngeal gonorrhea. However, patients’ tests were positive when providers’ tests were negative in six cases of rectal gonorrhea, nine cases of pharyngeal gonorrhea, three cases of rectal chlamydia, and two cases of pharyngeal chlamydia.

The prevalence of rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia using only the provider’s positive tests was 5.7%, 5.7%, 12%, and 1.1%. The prevalence using both the patients’ and providers’ positive results was 8.5%, 8.9%, 13.3%, and 1.8%, respectively.

There were no significant differences in the detection of gonorrhea between the patients and providers, Dr. Sexton said. Patients appeared to identify significantly more cases of gonorrhea, which might be due to false positives, cross-contamination, or more rigorous testing on the part of the patient, she noted.

Test results were no different based on whether the patient or the health care provider collected samples first.

Self-administered STD tests could reduce the time burden on health care providers and expand the number of MSM who are tested, said Dr. Sexton. In addition, informal feedback from patients suggested that, for the most part, the tests were easy to perform and more acceptable than allowing a health care provider to collect the samples.

"I talked to a lot of the patients, and many of them said they would prefer to do the testing on their own," Dr. Sexton said.

The results suggest that self-testing is a feasible option. However, some modifications need to be made to the testing instructions, and more research is needed to determine the best way to incorporate self-testing into a clinical setting, she noted.

Dr. Sexton had no financial conflicts to disclose. Test kits used in the study were provided by Gen-Probe.

QUEBEC CITY – Men who have sex with men can self-test for chlamydia and gonorrhea as effectively as health care providers can, according to findings from a study involving 286 adult men.

Data from previous studies show that the risk of HIV infection increases in men who have sex with men (MSM) who have other sexually transmitted diseases, said Dr. Marybeth Sexton of Columbia University, New York. Therefore, regular STD testing for MSM is important, however "less than 14% of physicians routinely screen male patients for chlamydia and gonorrhea," Dr. Sexton said at a congress of the International Society for Sexually Transmitted Diseases Research. Lack of time, lack of staff, and lack of knowledge were the reasons most often given for not screening.

In this study, Dr. Sexton and colleagues in Washington, D.C. compared the results of nucleic acid amplification testing (NAAT) for chlamydia and gonorrhea when MSM administered the tests themselves and when a health care provider administered the tests.

Patients were recruited from the Whitman-Walker Clinic in Washington, and they were eligible for the study if they reported having intercourse with a man within the past 6 months and if they wanted to be screened for rectal and pharyngeal chlamydia and gonorrhea.

The screening tests were performed twice on each patient, and the patients were randomized to initially perform self-tests or to be tested by a health care provider. For the self-test, patients were given instructional cards, and a health care provider was present, but offered no additional assistance.

Overall, both providers and patients had positive test results for 12 cases of rectal gonorrhea, 15 cases of pharyngeal gonorrhea, 25 cases of rectal chlamydia, and 3 cases of pharyngeal chlamydia. Both providers and patients had negative results for rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia in 193, 256, 183, and 277 tests, respectively.

The only time a provider’s test was positive and a patient’s test was negative was a single case of pharyngeal gonorrhea. However, patients’ tests were positive when providers’ tests were negative in six cases of rectal gonorrhea, nine cases of pharyngeal gonorrhea, three cases of rectal chlamydia, and two cases of pharyngeal chlamydia.

The prevalence of rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, and pharyngeal chlamydia using only the provider’s positive tests was 5.7%, 5.7%, 12%, and 1.1%. The prevalence using both the patients’ and providers’ positive results was 8.5%, 8.9%, 13.3%, and 1.8%, respectively.

There were no significant differences in the detection of gonorrhea between the patients and providers, Dr. Sexton said. Patients appeared to identify significantly more cases of gonorrhea, which might be due to false positives, cross-contamination, or more rigorous testing on the part of the patient, she noted.

Test results were no different based on whether the patient or the health care provider collected samples first.

Self-administered STD tests could reduce the time burden on health care providers and expand the number of MSM who are tested, said Dr. Sexton. In addition, informal feedback from patients suggested that, for the most part, the tests were easy to perform and more acceptable than allowing a health care provider to collect the samples.

"I talked to a lot of the patients, and many of them said they would prefer to do the testing on their own," Dr. Sexton said.

The results suggest that self-testing is a feasible option. However, some modifications need to be made to the testing instructions, and more research is needed to determine the best way to incorporate self-testing into a clinical setting, she noted.

Dr. Sexton had no financial conflicts to disclose. Test kits used in the study were provided by Gen-Probe.

QUEBEC CITY – The incidence of herpes simplex virus type 2 in the United States has remained stable within gender and ethnic groups over the past two decades, with young black women remaining at the highest risk for infection, according to an analysis of data from the National Health and Nutrition Examination Surveys for 1988-1994 and 1999-2008.

Herpes simplex virus type 2 (HSV-2) infections have a 16% seroprevalence among 14- to 49-year-olds in the United States, said Dr. Sarah M. Gerver of Imperial College, London, who presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Dr. Gerver and her associates at Imperial College and the Centers for Disease Control and Prevention in Atlanta combined NHANES data with a predictive model to estimate HSV-2 incidence per 100 person-years at risk.

Overall, the age-adjusted incidence rates over the past 20 years were stable in all sex and ethnic groups with two exceptions, the researchers noted. Incidence rates in Mexican-American women and non-Hispanic white women had decreased after 2001 and 2002, respectively.

The age-adjusted incidence of HSV-2 in non-Hispanic white men, non-Hispanic black men, and Mexican-American men remained stable at approximately 0.4, 1.4, and 0.7 per 100 person-years at risk, respectively. Non-Hispanic black women had the greatest incidence of HSV-2, which held steady over the study period at approximately 2.2 per 100 person-years at risk.

The incidence rate among 25-year-old non-Hispanic black women was more than 13 times greater than in white men of the same age, the researchers noted.

From 1988 to 2008, HSV-2 incidence rates peaked between ages 25-35 years for all sex and ethnic groups with the exception of Mexican-American men, for whom the incidence remained stable by age.

In 2007-2008, the most recent year included in the study, an estimated 753,519 new HSV-2 infections occurred among 14- to 49-year-olds in the United States, including 392,208 in men and 361,311 in women. Approximately 53% of the new infections in men occurred in non-Hispanic whites, and half of these occurred in men aged 18-29 years.

More than half of the HSV-2 infections in women occurred in those aged 14-24 years (204,550); including 40,520 in girls aged 14-17 years and 164,030 in young women aged 18-24 years.

And among women, "nearly 60% of all new infections were in non-Hispanic blacks, a group that accounts for less then 15% of the female population [in the U.S.]," the researchers noted.

The findings were limited by the researchers’ assumption of perfect comparability of the HSV-2 seroprevalence estimates across age, race, and time. But the stability of the long-term trends in HSV-2 incidence suggests a need for more targeted intervention programs, especially for those at highest risk, the researchers said.

"This information on the detailed distribution of new infections can help improve the efficiency of interventions," they wrote.

The researchers reported having no financial conflicts to disclose.

QUEBEC CITY – The incidence of herpes simplex virus type 2 in the United States has remained stable within gender and ethnic groups over the past two decades, with young black women remaining at the highest risk for infection, according to an analysis of data from the National Health and Nutrition Examination Surveys for 1988-1994 and 1999-2008.

Herpes simplex virus type 2 (HSV-2) infections have a 16% seroprevalence among 14- to 49-year-olds in the United States, said Dr. Sarah M. Gerver of Imperial College, London, who presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Dr. Gerver and her associates at Imperial College and the Centers for Disease Control and Prevention in Atlanta combined NHANES data with a predictive model to estimate HSV-2 incidence per 100 person-years at risk.

Overall, the age-adjusted incidence rates over the past 20 years were stable in all sex and ethnic groups with two exceptions, the researchers noted. Incidence rates in Mexican-American women and non-Hispanic white women had decreased after 2001 and 2002, respectively.

The age-adjusted incidence of HSV-2 in non-Hispanic white men, non-Hispanic black men, and Mexican-American men remained stable at approximately 0.4, 1.4, and 0.7 per 100 person-years at risk, respectively. Non-Hispanic black women had the greatest incidence of HSV-2, which held steady over the study period at approximately 2.2 per 100 person-years at risk.

The incidence rate among 25-year-old non-Hispanic black women was more than 13 times greater than in white men of the same age, the researchers noted.

From 1988 to 2008, HSV-2 incidence rates peaked between ages 25-35 years for all sex and ethnic groups with the exception of Mexican-American men, for whom the incidence remained stable by age.

In 2007-2008, the most recent year included in the study, an estimated 753,519 new HSV-2 infections occurred among 14- to 49-year-olds in the United States, including 392,208 in men and 361,311 in women. Approximately 53% of the new infections in men occurred in non-Hispanic whites, and half of these occurred in men aged 18-29 years.

More than half of the HSV-2 infections in women occurred in those aged 14-24 years (204,550); including 40,520 in girls aged 14-17 years and 164,030 in young women aged 18-24 years.

And among women, "nearly 60% of all new infections were in non-Hispanic blacks, a group that accounts for less then 15% of the female population [in the U.S.]," the researchers noted.

The findings were limited by the researchers’ assumption of perfect comparability of the HSV-2 seroprevalence estimates across age, race, and time. But the stability of the long-term trends in HSV-2 incidence suggests a need for more targeted intervention programs, especially for those at highest risk, the researchers said.

"This information on the detailed distribution of new infections can help improve the efficiency of interventions," they wrote.

The researchers reported having no financial conflicts to disclose.

QUEBEC CITY – The incidence of herpes simplex virus type 2 in the United States has remained stable within gender and ethnic groups over the past two decades, with young black women remaining at the highest risk for infection, according to an analysis of data from the National Health and Nutrition Examination Surveys for 1988-1994 and 1999-2008.

Herpes simplex virus type 2 (HSV-2) infections have a 16% seroprevalence among 14- to 49-year-olds in the United States, said Dr. Sarah M. Gerver of Imperial College, London, who presented the findings at a congress of the International Society for Sexually Transmitted Diseases Research.

Dr. Gerver and her associates at Imperial College and the Centers for Disease Control and Prevention in Atlanta combined NHANES data with a predictive model to estimate HSV-2 incidence per 100 person-years at risk.

Overall, the age-adjusted incidence rates over the past 20 years were stable in all sex and ethnic groups with two exceptions, the researchers noted. Incidence rates in Mexican-American women and non-Hispanic white women had decreased after 2001 and 2002, respectively.

The age-adjusted incidence of HSV-2 in non-Hispanic white men, non-Hispanic black men, and Mexican-American men remained stable at approximately 0.4, 1.4, and 0.7 per 100 person-years at risk, respectively. Non-Hispanic black women had the greatest incidence of HSV-2, which held steady over the study period at approximately 2.2 per 100 person-years at risk.

The incidence rate among 25-year-old non-Hispanic black women was more than 13 times greater than in white men of the same age, the researchers noted.

From 1988 to 2008, HSV-2 incidence rates peaked between ages 25-35 years for all sex and ethnic groups with the exception of Mexican-American men, for whom the incidence remained stable by age.

In 2007-2008, the most recent year included in the study, an estimated 753,519 new HSV-2 infections occurred among 14- to 49-year-olds in the United States, including 392,208 in men and 361,311 in women. Approximately 53% of the new infections in men occurred in non-Hispanic whites, and half of these occurred in men aged 18-29 years.

More than half of the HSV-2 infections in women occurred in those aged 14-24 years (204,550); including 40,520 in girls aged 14-17 years and 164,030 in young women aged 18-24 years.

And among women, "nearly 60% of all new infections were in non-Hispanic blacks, a group that accounts for less then 15% of the female population [in the U.S.]," the researchers noted.

The findings were limited by the researchers’ assumption of perfect comparability of the HSV-2 seroprevalence estimates across age, race, and time. But the stability of the long-term trends in HSV-2 incidence suggests a need for more targeted intervention programs, especially for those at highest risk, the researchers said.

"This information on the detailed distribution of new infections can help improve the efficiency of interventions," they wrote.

The researchers reported having no financial conflicts to disclose.