Prevalence of urine, rectal, and pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae among newly diagnosed Filipinos with HIV

Background: A syndromic approach likely underestimates prevalence of Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea) infection among Filipino people living with HIV (PLHIV). We determined urine, rectal, and pharyngeal prevalence of chlamydia and gonorrhea infection using nucleic acid testing (NAAT) in this population. Methods: This is a single-center, cross-sectional study performed at Philippine General Hospital. Following ethical approval and informed consent, urine, rectal, and pharyngeal samples from treatment-naïve adult PLHIV were tested using GeneXpert® for chlamydia and gonorrhoea. Participants with recent antibiotic use with activity against chlamydia or gonorrhoea were excluded. Demographic and clinical data were collected. Results: We enrolled 60 participants with median age of 30 years, 85% were male, 78% identified as men who have sex with men, and 95% were asymptomatic. The overall prevalence of chlamydia or gonorrhoea was 32%. Site-specific testing showed that rectal chlamydia or gonorrhoea infections were most common at 16.7%, followed by multisite infections at 10.0%. Conclusion: The prevalence of chlamydia and gonorrhoea among newly diagnosed Filipino PLHIV is 32% with 95% being asymptomatic. This is sufficiently high to warrant routine NAAT screening.