The Duality of Oral Sex for Men Who Have Sex with Men: An Examination Into the Increase of Sexually Transmitted Infections Amid the Age of HIV Prevention

Abstract Background The HIV Prevention Trials Network (HPTN) Study 073 (HPTN 073) assessed the feasibility, acceptability, and safety of preexposure prophylaxis (PrEP) for black men who have sex with men (BMSM). The purpose of this analysis was to characterize the relationship between PrEP uptake and use and incident sexually transmitted infections (STIs) among participants enrolled in HPTN 073. Methods A total of 226 human immunodeficiency virus (HIV)–uninfected BMSM were enrolled in 3 US cities; all participants received client-centered care coordination (C4) and were offered daily oral PrEP. Participants were followed for 12 months with STI testing (rectal and urine nucleic acid amplification test for gonorrhea and chlamydia, rapid plasma reagin for syphilis) conducted at baseline, week 26, and week 52. Logistic regression was used to examine associations between STI incidence and PrEP uptake. Generalized estimating equations were used to evaluate associations between age, PrEP acceptance, sexual behaviors, and incident STIs. Results Baseline STI prevalence was 14.2%. Men aged <25 years were more likely to have a baseline STI (25.3% vs 6.7%; odds ratio [OR], 4.39; 95% confidence interval [CI:, 1.91, 10.11). Sixty participants (26.5%) acquired ≥1 STI during follow-up; the incidence rate was 34.2 cases per 100 person-years (95% CI, 27.4, 42.9). In adjusted analyses, baseline STI diagnosis (OR, 4.23; 95% CI, 1.82, 9.87; P < .001) and additional C4 time (OR, 1.03; 95% CI, 1.00, 1.06; P = .027) were associated with having an incident STI. STI incidence was not associated with PrEP acceptance or adherence. Conclusions While we found higher rates of STIs in younger BMSM, overall rates of STI were lower than in prior PrEP trials, with no increase over time. BMSM with STIs at PrEP initiation may require additional interventions that target STI acquisition risk. Clinical Trials Registration NCT01808352.

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502Modelling Chlamydia trachomatis and Mycoplasma genitalium transmission in men who have sex with men

International Journal of Epidemiology ◽

10.1093/ije/dyab168.729 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Xianglong Xu ◽

Christopher K Fairley ◽

Lei Zhang

Keyword(s):

Chlamydia Trachomatis ◽

Mathematical Models ◽

Sexually Transmitted Infections ◽

Mycoplasma Genitalium ◽

Compartmental Models ◽

Sexual Practices ◽

Oral Sex ◽

Anal Sex ◽

Sexually Transmitted ◽

Sex With Men

Abstract Background Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) are two common sexually transmitted infections in men who have sex with men that are assumed to be transmitted only by oral and anal sex. However, this assumption has not been tested in mathematical models before. Methods To test a variety of potential transmission routes against the known proportion of infections at the oropharynx, mouth and anus, we established 20 compartmental models involving different sexual practices. We tested transmission by a) only anal sex and oral sex; b) adding rimming and kissing to anal and oral sex, and c) adding sequential sexual practices (e.g. oral sex followed by oral-anal sex (rimming) or vice versa. Results We could not replicate the proportion of anatomical sites infected with CT using anal or oral sex alone or by adding riming and kissing. However, if we included sequential sexual practices, then we were able to replicate the prevalence of CT at each site including infection at more than one site. In contrast, we were able to replicate infection for MG at the three sites using transmission routes that involved only anal sex and oral sex without the need for adding any other routes of transmission. Conclusions Our model indicates that more complicated transmission routes are required to explain the observed prevalence of infection with CT, but that for MG transmission involving only anal and oral sex is sufficient. Key messages Unlike CT, MG transmission does not require more complicated transmission routes.

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Faculty Opinions recommendation of Treatment of sexually transmitted infections for HIV prevention: end of the road or new beginning?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718076709.793482232 ◽

2013 ◽

Author(s):

David Earn ◽

David Champredon

Keyword(s):

Hiv Prevention ◽

Sexually Transmitted Infections ◽

Sexually Transmitted ◽

The Road ◽

New Beginning

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Faculty of 1000 evaluation for Beyond Anal Sex: Sexual Practices of Men Who Have Sex With Men and Associations With HIV and Other Sexually Transmitted Infections.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.726132536.793516027 ◽

2016 ◽

Author(s):

Chiara Simonelli ◽

Stefano Eleuteri ◽

Roberta Rossi

Keyword(s):

Sexually Transmitted Infections ◽

Sexual Practices ◽

Anal Sex ◽

Sexually Transmitted ◽

Sex With Men

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Testing as Prevention of Resistance in Bacteria Causing Sexually Transmitted Infections—A Population-Based Model for Germany

Antibiotics ◽

10.3390/antibiotics10080929 ◽

2021 ◽

Vol 10 (8) ◽

pp. 929

Author(s):

Andreas Hahn ◽

Hagen Frickmann ◽

Ulrike Loderstädt

Keyword(s):

Sexually Transmitted Infections ◽

False Negative ◽

Population Based ◽

Sexually Transmitted ◽

Test Characteristics ◽

Antibiotic Drugs ◽

False Positive Signal ◽

Antibiotic Drug ◽

Potential Applicability ◽

Sex With Men

Prescribed antibiotic treatments which do not match the therapeutic requirements of potentially co-existing undetected sexually transmitted infections (STIs) can facilitate the selection of antibiotic-drug-resistant clones. To reduce this risk, this modelling assessed the potential applicability of reliable rapid molecular test assays targeting bacterial STI prior to the prescription of antibiotic drugs. The modelling was based on the prevalence of three bacterial STIs in German heterosexual and men-having-sex-with-men (MSM) populations, as well as on reported test characteristics of respective assays. In the case of the application of rapid molecular STI assays for screening, the numbers needed to test in order to correctly identify any of the included bacterial STIs ranged from 103 to 104 for the heterosexual population and from 5 to 14 for the MSM population. The number needed to harm—defined as getting a false negative result for any of the STIs and a false positive signal for another one, potentially leading to an even more inappropriate adaptation of antibiotic therapy than without any STI screening—was at least 208,995 for the heterosexuals and 16,977 for the MSM. Therefore, the screening approach may indeed be suitable to avoid unnecessary selective pressure on bacterial causes of sexually transmitted infections.

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