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This version was published on 1 November 2009
Int J STD AIDS 2009;20:741-744
doi:10.1258/ijsa.2009.009176
© 2009 Royal Society of Medicine Press

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Debate

Questioning the value of screening for gonorrhoea in symptomless heterosexual men

R Pittrof MSc MRCOG *, S Hitchings MRCOG MFSRH * and M FitzGerald FRCP FFSRH {dagger} 

* Department of Reproductive & Sexual Health, Enfield Primary Care Trust, Enfield; {dagger} Department of Genitourinary Medicine, Musgrove Park Hospital, Taunton, Somerset TA1 5DA, UK

Correspondence to: Dr M FitzGerald Email: gu.med{at}tst.nhs.uk

These two papers discuss whether gonorrhoea screening of asymptomatic heterosexual men with no contact history should continue in UK genitourinary medicine clinics. Currently, most clinics routinely test all attenders. This requires an estimated 330,000 tests annually to detect 915 positives (1 in 361). The benefits to these patients are uncertain but the costs are huge and could fund currently unprovided services such as oral contraceptive provision or HIV testing before terminations of pregnancy. However stopping testing would deny individuals the reassurance they seek, prevent early detection of outbreaks and fail to detect carriers who go on to cause morbidity in their partners. On this view, the availability of non-invasive tests should be used to widen screening.

Key Words: screening • asymptomatic • gonorrhoea • cost-effectiveness

 

Screening symptomless heterosexual men for gonorrhoea does not make the most effective use of sexual health clinic resources

R Pittrof and S Hitchings

 

Gonorrhoea screening is an essential part of a genitourinary medicine service

M FitzGerald


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