Should we screen heterosexuals for extra-genital chlamydial and gonococcal infections?

Int J STD AIDS. 2015 Jun;26(7):462-6. doi: 10.1177/0956462414543120. Epub 2014 Jul 10.


Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) are two of the most prevalent bacterial sexually transmitted infections in the UK. Although the high burden of extra-genital infections with GC and CT in men who have sex with men has been well established, a significant number of extra-genital site infections with CT and GC could similarly be present in heterosexual women. For this reason we started to routinely offer extra-genital site testing for GC and CT in all patients attending our sexual health clinic who reported having had receptive anal sex and/or giving oral sex. This followed a review of current evidence by the clinical team and a change in local testing policy. This study not only confirmed a large reservoir of extra-genital infection amongst men who have sex with men, but also demonstrates that a comparable reservoir of extra-genital infection is present amongst heterosexual women. Our study adds to the mounting evidence that extra-genital site testing in heterosexual women should occur when oral or anal sexual activity is reported.

Keywords: Heterosexual; chlamydia; extra-genital infection; gonorrhoea; pharyngeal; rectal; screening; sexually transmitted infection; throat; women.

MeSH terms

  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / microbiology
  • Chlamydia trachomatis / isolation & purification
  • Cohort Studies
  • Female
  • Gonorrhea / diagnosis*
  • Gonorrhea / epidemiology
  • Gonorrhea / microbiology
  • Heterosexuality*
  • Humans
  • Male
  • Mass Screening / economics
  • Mass Screening / methods*
  • Neisseria gonorrhoeae / isolation & purification
  • Nucleic Acid Amplification Techniques
  • Pharynx / microbiology*
  • Prevalence
  • Rectum / microbiology*
  • United Kingdom / epidemiology
  • Urban Population