• E L Ciemins, C K Kent, J Flood, and J D Klausner.
• San Francisco Department of Public Health, Sexually Transmitted Disease Prevention and Control Services, California, USA.
• Sex Transm Dis. 2000 Mar 1;27(3):165-7.

Background And ObjectivesThe 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 in an attempt to target populations at greatest risk. Screening among populations with a < 2% prevalence of chlamydia and a < 1% prevalence of gonorrhea may not be cost-effective.GoalTo identify subpopulations with a low prevalence of chlamydia or gonorrhea.Study DesignThe prevalence of genital chlamydia and gonorrhea among asymptomatic STD patients screened from 1997 to 1998 at San Francisco City Clinic was stratified by demographic and behavioral risk factors.ResultsThe 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 were women older than 29 years (chlamydia, 1.2%) and men who have sex with women (gonorrhea, 0.8%).ConclusionsThese data identified low-prevalence subpopulations among asymptomatic STD patients. As a result, the STD screening criteria at San Francisco City Clinic were changed accordingly.

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