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No guidelines recommend rectal screening for sexually transmitted infections (STIs) in women; however, such testing might augment overall detection of STIs, even in women without histories of anal intercourse. In response to survey results that indicated unexpectedly high rates of anal intercourse in women, San Francisco's municipal STI clinic began testing women for rectal chlamydia and gonorrhea. Researchers evaluated whether this practice improved STI case-finding and whether anal intercourse was a risk factor for rectal infection.
From March 2007 to August 2008, 1308 women who underwent pelvic examinations (57% of whom had vaginal discharge) also underwent rectal and vaginal tests for chlamydia and gonorrhea. In all, 79 women tested posi…