Interconnected anatomical symbols representing STI transmission.

STI Hotspots: Where You're Most at Risk and How to Stay Safe

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Theo Raines in Health & Wellness November 2025 • 5 min read.

"A Deep Dive into the Latest Research on Chlamydia and Gonorrhea Prevalence in the HIV-Positive Community and What It Means for You."


Sexually transmitted infections (STIs) are a significant public health concern, impacting millions globally. While often discussed in general terms, the prevalence and patterns of STIs can vary considerably among different populations. One such population is individuals living with human immunodeficiency virus (HIV), who may face unique challenges and risks related to STIs.

A recent study presented at IDWeek 2015 sheds light on the prevalence of two common STIs—chlamydia and gonorrhea—among HIV-positive men. The research, conducted at Denver Health, examined the rates of these infections based on the anatomical site (urine, rectal, and oral) and the presence or absence of symptoms. The findings reveal intriguing patterns that challenge conventional wisdom and highlight the importance of targeted screening strategies.

This article delves into the details of this study, exploring its methodology, key findings, and implications for STI prevention and management. We'll uncover the anatomical hotspots where these infections are most prevalent, discuss the role of symptoms in detection, and provide practical advice on how to stay safe and protect your health. Whether you're an HIV-positive individual, a healthcare provider, or simply someone interested in staying informed about sexual health, this article offers valuable insights into the evolving landscape of STIs.

Unmasking the Prevalence: Key Findings from the Denver Health Study

Interconnected anatomical symbols representing STI transmission.

The Denver Health study meticulously reviewed 5755 GC/CT tests conducted over a three-year period. A significant portion of these tests (81%) were for screening purposes, while the remaining 19% were diagnostic, prompted by the presence of symptoms. Overall, 5% of all tests came back positive for either gonorrhea (GC) or chlamydia (CT). However, this overall positivity rate masked considerable variation depending on the type of test and the anatomical site.

One of the most striking findings was the difference in positivity rates between diagnostic and screening tests. Diagnostic tests, conducted on individuals experiencing symptoms, were significantly more likely to be positive (10%) compared to screening tests (3%; P<.001). This highlights the importance of seeking medical attention if you experience any symptoms suggestive of an STI.

Key takeaways from the study:
  • Rectal infections were more common: Rectal tests showed higher rates of positivity compared to pharyngeal and urine tests.
  • Asymptomatic infections are prevalent: In the absence of symptoms, rectal chlamydia was the most prevalent infection.
  • Symptoms matter: Genito-urinary symptoms were more often associated with infection.
The study also revealed that the anatomical site of testing significantly impacted positivity rates. Rectal tests, in particular, stood out as having the highest positivity rates. Rectal tests were positive more often than pharyngeal or urine tests (10% versus 5% and 3%; P<.001). When considering combined GC/CT positivity rates, diagnostic rectal tests (16%) and urine tests (10%) topped the list, followed by screening rectal tests (9%). Interestingly, in the absence of symptoms, rectal chlamydia emerged as the most prevalent infection (12%), followed by pharyngeal gonorrhea (6%) and rectal gonorrhea (5%). This finding underscores the importance of routine screening, even in the absence of symptoms, as many infections may go undetected otherwise.

Empowering You: Taking Control of Your Sexual Health

The findings from the Denver Health study offer valuable insights into the prevalence and patterns of STIs among HIV-positive men. By understanding the anatomical hotspots for infection and the importance of routine screening, you can take proactive steps to protect your health and well-being. Remember, open communication with your healthcare provider, regular STI testing, and safe sexual practices are essential components of a comprehensive sexual health strategy. Stay informed, stay proactive, and prioritize your health.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1093/ofid/ofv131.39, Alternate LINK

Title: Prevalence Of Gonorrhea And Chlamydia Infections Among Human Immunodeficiency Virus-Infected Men By Anatomic Site And Presence Or Absence Of Symptoms

Subject: Infectious Diseases

Journal: Open Forum Infectious Diseases

Publisher: Oxford University Press (OUP)

Authors: Renna Short, Edward Gardner, Joshua Blum, Shawni Vaughn, Sarah Rowan

Published: 2015-01-01

Everything You Need To Know

1

What were the key findings of the Denver Health study regarding chlamydia and gonorrhea prevalence among HIV-positive men?

The Denver Health study found that diagnostic tests for gonorrhea (GC) or chlamydia (CT) on individuals experiencing symptoms had a 10% positivity rate, while screening tests on asymptomatic individuals had a 3% positivity rate. Rectal tests showed higher rates of positivity compared to pharyngeal and urine tests, and in the absence of symptoms, rectal chlamydia was the most prevalent infection. This highlights the significance of both diagnostic testing when symptoms are present and routine screening for asymptomatic infections.

2

Which anatomical sites showed the highest rates of STI positivity in the Denver Health study, and what does this imply for testing strategies?

The Denver Health study highlighted that rectal infections, specifically rectal chlamydia, were more prevalent, even in the absence of symptoms. Diagnostic rectal tests had a 16% positivity rate, and screening rectal tests had a 9% positivity rate, underscoring the importance of including rectal screening in STI testing protocols, especially for HIV-positive individuals. It also revealed that genito-urinary symptoms were more often associated with infection, suggesting these areas are also high risk.

3

Why is routine STI screening so important, especially in light of the Denver Health study's findings on asymptomatic infections?

Routine screening for STIs like chlamydia and gonorrhea is crucial because the Denver Health study revealed that many infections, particularly rectal chlamydia, are asymptomatic. The study found that in the absence of symptoms, rectal chlamydia was the most prevalent infection, followed by pharyngeal gonorrhea and rectal gonorrhea. Regular screening helps detect and treat these infections early, preventing potential complications and further transmission.

4

What are the potential long-term consequences of untreated chlamydia and gonorrhea, particularly for individuals living with HIV? The study did not explicitly address this, but what are the known risks?

The study did not specifically address the long-term consequences of untreated chlamydia and gonorrhea in HIV-positive individuals; however, it is well-documented that untreated STIs can lead to serious health issues. These may include pelvic inflammatory disease, infertility, increased risk of ectopic pregnancy, and heightened HIV transmission rates. Furthermore, co-infection with HIV and STIs can complicate treatment and management strategies, underscoring the importance of regular screening and prompt treatment.

5

Based on the insights from the Denver Health study, what practical steps can I take to protect my sexual health and reduce my risk of STIs, particularly if I am HIV-positive?

To protect your sexual health, especially if you are HIV-positive, it is essential to practice safe sex, including consistent and correct condom use. Open communication with your healthcare provider is also crucial for regular STI testing based on your individual risk factors and sexual practices. Given the Denver Health study's findings, ensure that testing includes all relevant anatomical sites (urine, rectal, and oral) and seek medical attention promptly if you experience any symptoms suggestive of an STI.

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