{"doi":"10.1093/cid/ciab680","title":"The Natural History of Rectal Gonococcal and Chlamydial Infections: The ExGen Study","abstract":"BACKGROUND: The duration of rectal gonococcal and chlamydial infection remains unknown. This basic epidemiologic parameter is needed to understand transmission dynamics. METHODS: We conducted a prospective, longitudinal, observational cohort study of 140 men who have sex with men (MSM) at risk of gonorrhea and chlamydia acquisition. For 48 weeks, enrolled men collected rectal swabs (Aptima multi-test kit) at home and responded to an electronic survey about sexual behavior and health conditions weekly. Swabs remained untested until participants completed the study. We used Kaplan-Meier estimates to determine the median duration of infection, censoring infections for treatment, loss to follow-up, and end-of-study. We used log-rank test to compare duration of infection by human immunodeficiency virus (HIV) status, history of infection with gonorrhea or chlamydia, and coinfection with the other pathogen. RESULTS: 140 enrolled MSM contributed 70.5 person-years of follow-up. Eighteen men had 20 incident rectal gonococcal infections, which persisted for 2-23 weeks; 30% were censored for treatment. The estimated median duration of rectal gonorrhea was 9 weeks (95% confidence interval [CI]: 3-12 weeks). Twenty-four men experienced 32 rectal chlamydial infections, persisting between 2 and 42 weeks; 60% were censored. The estimated duration of rectal chlamydia was 13 weeks (95% CI: 6 weeks-undefined). There were no differences in the duration of rectal gonorrhea or chlamydia by HIV status, history of chlamydia/gonorrhea, or coinfection. CONCLUSIONS: On average, rectal gonorrhea and chlamydial infections last 2-3 months, although some infections persisted for 6-11 months. Further understanding into predictors of persistence is needed.","journal":"Clinical Infectious Diseases","year":2021,"id":166858,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":33,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9102,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":490006,"name":"Christine M. Khosropour","orcid":"0000-0002-9743-0829","position":1,"is_corresponding":false},{"id":316703,"name":"Olusegun O. Soge","orcid":"0000-0002-8504-2319","position":2,"is_corresponding":false},{"id":316704,"name":"James P. Hughes","orcid":"0000-0001-5034-3157","position":3,"is_corresponding":false},{"id":648888,"name":"Micaela Haglund","orcid":null,"position":4,"is_corresponding":false},{"id":657135,"name":"Winnie Wan Yin Yeung","orcid":"0000-0002-1785-4921","position":5,"is_corresponding":false},{"id":311289,"name":"Matthew R. Golden","orcid":"0000-0001-7449-3774","position":6,"is_corresponding":false},{"id":444182,"name":"Lindley A. Barbee","orcid":"0000-0002-7189-5492","position":0,"is_corresponding":true}],"reference_count":16,"raw_metadata":null,"created_at":"2026-07-18T23:45:49.644768Z","pmid":"34355734","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}