Screening for Gonorrhea: Recommendation Statement

Dear Editor,

Having read the recommendation statement on gonorrhea [1], the following is submitted for consideration. The statement acknowledges the current epidemiological evidence suggesting that gonococcal infection facilitates susceptibility to and transmission of HIV in both men and women [2]. The literature is however replete with the co-existence of gonorrhea and HIV. Other co-existing sexually transmitted infections would normally be readily obvious to a treating physician, and can be therefore dealt with in tandem. The dose of recommended drugs will have to be suitably amended depending on the concurrent infection. The point I would like to emphasize is that the rapid screening for HIV simultaneously should be considered to be incorporated while screening for gonorrhea. It is granted that patients and providers are worried of the potential harms of screening and treatment for gonorrhea itself. But would it not amount to neglect for not having cared to detect for HIV at the same go. This way at least some cases can be detected early and therefore will have proper follow up care instituted timely for better prospects and outcome. Moreover the recommendations have left out contact tracing and further appropriate follow up care. Whatever decisions and guidelines that you build up are being incorporated elsewhere too, without much changes. Hence the requirement for giving this submission a due thought for the benefit of patients.

With regards.

Dr. Rajesh Chauhan.

1. U.S. Preventive Services Task Force. Screening for Gonorrhea: Recommendation Statement. Annals of Family Medicine 2005; 3: 263-267. 2. Farley TA, Cohen DA, Wu SY, Besch CL. The value of screening for sexually transmitted diseases in an HIV clinic. J Acquir Immune Defic Syndr 2003; 33: 642–648.

Competing interests:   None declared