Evaluation of chlamydia and gonorrhea screening criteria - San Francisco sexually transmitted disease clinic: 1997 to 1998

Background and Objectives: The advent of more sensitive diagnostic testing technologies and competition in public healthcare spending have resulted in a reevaluation of sexually transmitted disease (STD) screening practices i n an attempt to target populations at greatest risk, Screening among popula tions with a < 2% prevalence of chlamydia and a < 1% prevalence of gonorrhe a may not be cost-effective. Goal: To identify subpopulations with a low prevalence of chlamydia or gono rrhea. Study Design: The prevalence of genital chlamydia and gonorrhea among asymp tomatic STD patients screened from 1997 to 1998 at San Francisco City Clini c was stratified by demographic and behavioral risk factors. Results: The prevalence of chlamydia and gonorrhea was 3.4% and 1.1% among asymptomatic women and 4.0% and 1.0% among asymptomatic men, respectively. Two low-prevalence subpopulations identified among asymptomatic patients we re women older than 29 years (chlamydia, 1.2%) and men who have sex with wo men (gonorrhea, 0.8%), Conclusions: These data identified low-prevalence subpopulations among asym ptomatic STD patients. As a result, the STD screening criteria at San Franc isco City Clinic were changed accordingly.