TOPLINE:

Systematic screening for Chlamydia trachomatis and Neisseria gonorrhoeae at oral, anal, and vaginal sites could increase case detection rates compared with traditional vaginal-only testing in women.

METHODOLOGY:

• Researchers conducted a multicentre prospective cohort study comparing systematic three-site screening at oral, vaginal, and anal sites vs vaginal-only testing to detect C trachomatis and N gonorrhoeae in women who did not identify as sex workers.
• A total of 1498 women who attended free-of-charge sexually transmitted infection screening centres in France (median age, 23.7 years) completed a questionnaire and were offered three-site sampling; 1483 oral, 1492 vaginal, and 1278 anal samples were obtained, and 1274 women completed sampling at all three sites.
• The samples were tested using multiplex real-time polymerase chain reaction nucleic acid amplification to detect C trachomatis and N gonorrhoeae.
• Detection rates between three-site testing and vaginal-only testing were compared within the same woman using paired analyses.

TAKEAWAY:

• Systematic three-site testing detected more infections than vaginal-only testing, raising the overall detection from 10.1% to 13.8%; among women who completed sampling at all three sites, detection rose from 10.0% to 12.0% (P < .001 for both comparisons).
• For C trachomatis, detection increased from 9.2% to 12.4% overall and from 9.0% to 10.7% among women who completed sampling at all three sites (P < .001 for both comparisons).
• For N gonorrhoeae, detection rose from 1.4% to 2.4% overall (P = .008) and from 1.6% to 2.2% among women who completed sampling at all three sites (P = .01).
• Among positive patients with complete data, 16.4% had infections detected in only oral and/or anal sites without vaginal involvement, and symptoms and reported sexual practices did not reliably predict infection.

IN PRACTICE:

"This study demonstrates that multisite testing significantly enhances STI [sexually transmitted infection] detection across the general population, compared to the limitations of selective testing that rely solely on reported sexual behaviours. We advocate that embracing this approach could help combat and curb the ongoing STI epidemics that challenge public health today," the authors wrote.

SOURCE:

This study was led by Thierry Prazuck, Service des maladies infectieuses et tropicales, CHU d'Orléans, Orléans, France. It was published online on February 12, 2026, in Clinical Microbiology and Infection.

LIMITATIONS:

The study faced challenges with compliance as 15% of participants did not complete anal sampling. Additionally, potential site documentation mismatches in self-collection of samples could have affected the results.

DISCLOSURES:

This study was supported by the University Hospital of Orléans. No conflicts of interest were stated in the article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.