Proctitis in gay and bisexual men. Are microscopy and proctoscopy worthwhile?

2020 ◽  
Vol 96 (7) ◽  
pp. 475-477
Author(s):  
Gwamaka Eliudi Mwasakifwa ◽  
Colleen Nugent ◽  
Rick Varma
Keyword(s):  
Health Centre ◽  
Positive Likelihood Ratio ◽  
Mycoplasma Genitalium ◽  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Nucleic Acid Amplification ◽  
Receptive Anal Intercourse ◽  
Polymorphonuclear Cells ◽  
Bisexual Men ◽  
And Bisexual

ObjectivesWe explored the association between nucleic acid amplification testing (NAAT) and rectal microscopy/proctoscopy findings and correlates of rectal STIs among 150 gay and bisexual men (GBM) diagnosed with proctitis at the Sydney Sexual Health Centre from March 2016 to October 2017.MethodsFrom case files, we analysed risk behaviours, microscopy, proctoscopy and NAAT results for rectal STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, herpes simplex virus type 1/2, lymphogranuloma venereum and syphilis). χ2 test assessed the association between microscopy/proctoscopy findings and NAAT results. Linear regression assessed the association between NAAT positivity and correlates of rectal STIs.ResultsThe mean age was 32.5 (9.8) years, 43% (65/150) were taking pre-exposure prophylaxis, 17% (26/150) were HIV positive and 24% (36/147) had multiple rectal STIs.Among GBM with documented proctoscopy findings (n=113), 58% (65/113) had discharge, 36% (41/113) had anorectal erythema and 25% (28/113) had bleeding. A quarter of GBM (28/113) had negative proctoscopy findings.Discharge found on proctoscopy (p=0.001), positive HIV status (p=0.030) and time since last receptive anal intercourse (p=0.028) were independently associated with NAAT positivity for any rectal STI. Discharge had a positive likelihood ratio of 1.6 (95% CI 1.0 to 2.4).Among those with documented microscopy findings (n=69), 59% (41/69) and 41% (28/69) were NAAT positive and negative, respectively. Among NAAT-positive GBM, 27 (66%) had polymorphonuclear cells (PMNs) (mean number of PMNs, 10 (SD 9) cells per oil immersion field), 1 (2%) had Gram-negative intracellular diplococci and 11 (27%) had negative findings. There was no significant association between microscopy findings and NAAT results (p=0.651) or the number of rectal STI (p=0.279).ConclusionMicroscopy does not reliably provide information necessary to tailor the management of GBM diagnosed with proctitis. Discharge found during proctoscopy may identify GBM with rectal STI. Services should consider recommendations to perform these investigations.

scholarly journals Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea: a cross-sectional study in men who have sex with men

2019 ◽  
Vol 95 (7) ◽  
pp. 516-521 ◽  
Author(s):  
Eric P F Chow ◽  
Vincent J Cornelisse ◽  
Deborah A Williamson ◽  
David Priest ◽  
Jane S Hocking ◽  
...  
Keyword(s):  
Health Centre ◽  
Significant Proportion ◽  
Gay And Bisexual Men ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification ◽  
Bisexual Men ◽  
Sex Partners ◽  
Cross Sectional ◽  
And Bisexual ◽  
Sex With Men

ObjectivesA mathematical model suggested that a significant proportion of oropharyngeal gonorrhoea cases are acquired via oropharynx-to-oropharynx transmission (ie, tongue-kissing), but to date, no empirical study has investigated this. This study aimed to examine the association between kissing and oropharyngeal gonorrhoea among gay and bisexual men who have sex with men (MSM).MethodsMSM attending a public sexual health centre in Melbourne, Australia, between March 2016 and February 2017 were invited to participate in a brief survey that collected data on their number of male partners in the last 3 months, in three distinct categories: kissing-only (ie, no sex including no oral and/or anal sex), sex-only (ie, any sex without kissing), and kissing-with-sex (ie, kissing with any sex). Univariable and multivariable logistic regression analyses were performed to examine associations between oropharyngeal gonorrhoea positivity by nucleic acid amplification tests and the three distinct partner categories.ResultsA total of 3677 men completed the survey and were tested for oropharyngeal gonorrhoea. Their median age was 30 (IQR 25–37) and 6.2% (n=229) had oropharyngeal gonorrhoea. Men had a mean number of 4.3 kissing-only, 1.4 sex-only, and 5.0 kissing-with-sex partners in the last 3 months. Kissing-only and kissing-with-sex were associated with oropharyngeal gonorrhoea, but sex-only was not. The adjusted odds for having oropharyngeal gonorrhoea were 1.46-fold (95% CI 1.04 to 2.06) for men with ≥4 kissing-only partners and 1.81-fold (95% CI 1.17 to 2.79) for men with ≥4 kissing-with-sex partners.ConclusionsThese data suggest that kissing may be associated with transmission of oropharyngeal gonorrhoea in MSM, irrespective of whether sex also occurs.

scholarly journals Correlates of Unprotected Receptive Anal Intercourse Among Gay and Bisexual Men: Kampala, Uganda

2009 ◽  
Vol 13 (4) ◽  
pp. 677-681 ◽  
Author(s):  
H. Fisher Raymond ◽  
Phoebe Kajubi ◽  
Moses R. Kamya ◽  
George W. Rutherford ◽  
Jeffrey S. Mandel ◽  
...  
Keyword(s):  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Bisexual Men ◽  
Unprotected Receptive Anal Intercourse ◽  
And Bisexual

scholarly journals General practitioner awareness of sexual orientation among a community and internet sample of gay and bisexual men in New Zealand

2015 ◽  
Vol 7 (3) ◽  
pp. 204 ◽  
Author(s):  
Adrian Ludlam ◽  
Peter Saxton ◽  
Nigel Dickson ◽  
Anthony Hughes
Keyword(s):  
General Practice ◽  
Sexual Orientation ◽  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Bisexual Men ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Hiv Test ◽  
And Bisexual ◽  
Sex With Men

INTRODUCTION: General practitioners (GPs) can improve HIV and sexually transmitted infection (STI) screening, vaccination and wellbeing among gay, bisexual and other men who have sex with men (GBM) if they are aware of a patient?s sexual orientation. AIM: To estimate GP awareness of their GBM patients' sexual orientation and examine whether HIV and STI screening was associated with this. METHODS: We analysed anonymous, self-completed data from 3168 GBM who participated in the community-based Gay Auckland Periodic Sex Survey (GAPSS) and internet-based Gay men's Online Sex Survey (GOSS) in 2014. Participants were asked if their usual GP was aware of their sexual orientation or that they had sex with men. RESULTS: Half (50.5%) believed their usual GP was aware of their sexual orientation/behaviour, 17.0% were unsure, and 32.6% believed he/she was unaware. In multivariate analysis, GP awareness was significantly lower if the respondent was younger, Asian or an 'Other' ethnicity, bisexual-identified, had never had anal intercourse or had first done so very recently or later in life, and had fewer recent male sexual partners. GBM whose GP was aware of their sexual orientation were more likely to have ever had an HIV test (91.5% vs 57.9%; p<0.001), specific STI tests (91.7% vs 68.9%; p<0.001), and were twice as likely to have had an STI diagnosed. DISCUSSION: Lack of sexual orientation disclosure is resulting in missed opportunities to reduce health inequalities for GBM. More proactive, inclusive and safe environments surrounding the care of sexual orientation minorities are needed in general practice to encourage disclosure. KEYWORDS: Culturally competent care; general practice; HIV; HPV; sexual health; sexual orientation

The Impact of Stressful Life Events on Unprotected Anal Intercourse Among Gay and Bisexual Men

2011 ◽  
Vol 16 (3) ◽  
pp. 633-643 ◽  
Author(s):  
Liviana M. Calzavara ◽  
Ann N. Burchell ◽  
Gerald Lebovic ◽  
Ted Myers ◽  
Robert S. Remis ◽  
...  
Keyword(s):  
Life Events ◽  
Stressful Life Events ◽  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Stressful Life ◽  
Bisexual Men ◽  
And Bisexual ◽  
The Impact

Risk factors for HIV seroconversion in homosexual men in Australia

Sexual Health ◽  
2006 ◽  
Vol 3 (1) ◽  
pp. 45 ◽  
Author(s):  
Jonathan E. Volk ◽  
Garrett Prestage ◽  
Fengyi Jin ◽  
John Kaldor ◽  
Jeanne Ellard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Recreational Drug ◽  
Bisexual Men ◽  
Recreational Drug Use ◽  
Hiv Seroconversion ◽  
And Bisexual

Background: Rates of newly acquired HIV infection are increasing in Australia, and sexual contact between men accounts for 85% of cases. Objective: To investigate behavioural risk factors for HIV seroconversion among gay and bisexual men from Sydney and Melbourne, Australia. Methods: 103 men with newly acquired HIV infection were recruited from clinics in Sydney and Melbourne and behavioural risk factor questionnaires were administered between January 2003 and October 2004. Results were compared with a cross sectional and a cohort study performed by our group that enrolled similar populations of men. Results: The majority of seroconverters (73%) reported more than five sexual partners in the last six months. Ninety-five men (92%) were able to identify a high-risk event (HRE) that they thought had led to their HIV seroconversion. Most (70%) reported receptive unprotected anal intercourse (UAI), insertive UAI, or both at their HRE. Sixteen men (16%) reported no UAI in the preceding six months including the HRE. Men were more likely to report receptive UAI at their HRE when they perceived a partner to be HIV-negative as compared with when they perceived a partner to be HIV-positive (P = 0.05). Injection drug use was reported by 22% of the men in the previous six months, and 62% reported intoxication with alcohol (≥5 drinks) or mood altering recreational drug use at the HRE. Conclusions: Gay and bisexual men who have recently seroconverted are highly sexually active and report high rates of unprotected anal intercourse and recreational drug use at the HRE.

Predictors of Unprotected Anal Intercourse Among HIV-Positive Latino Gay and Bisexual Men

2004 ◽  
Vol 8 (4) ◽  
pp. 379-389 ◽  
Author(s):  
Paul J. Poppen ◽  
Carol A. Reisen ◽  
Mar�a Cecilia Zea ◽  
Fernanda T. Bianchi ◽  
John J. Echeverry
Keyword(s):  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Hiv Positive ◽  
Bisexual Men ◽  
And Bisexual

scholarly journals Impact of victimization during youth on adult high-risk sexual behaviour among gay and bisexual men

2021 ◽  
Author(s):  
Tyler G. Tulloch
Keyword(s):  
High Risk ◽  
Social Anxiety ◽  
Sexual Behaviour ◽  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Bisexual Men ◽  
High Risk Sexual Behaviour ◽  
And Bisexual ◽  
Risk Sexual Behaviour

Based on the minority stress model, this study examines the impact of general and gay-specific childhood teasing on adult high-risk sexual behaviour among gay and bisexual men, mediated by depression and social anxiety. High-risk sexual behaviour was operationalized as the number of acts of unprotected anal intercourse with a partner of opposite or unknown HIV status, and also as the number of partners of opposite or unknown HIV status with whom an individual engaged in unprotected anal intercourse. Depression, social anxiety, and retrospective self-report of childhood teasing were measured at baseline, and sexual behaviour was measured at 6-month follow-up. Results indicate that gay-specific teasing, but not general teasing, was indirectly associated with number of high-risk sex acts via depression. Additionally, both types of teasing were directly associated with number of high-risk sex partners after accounting for depression and social anxiety.

Frequent condom use with casual partners varies by sexual position among younger gay and bisexual men in New Zealand: national behavioural surveillance 2006–2011

Sexual Health ◽  
2016 ◽  
Vol 13 (1) ◽  
pp. 81 ◽  
Author(s):  
Nathan J. Lachowsky ◽  
Peter J. W. Saxton ◽  
Anthony J. Hughes ◽  
Nigel P. Dickson ◽  
Robin R. Milhausen ◽  
...  
Keyword(s):  
New Zealand ◽  
Condom Use ◽  
Anal Intercourse ◽  
Multivariable Logistic Regression Analysis ◽  
Receptive Anal Intercourse ◽  
Bisexual Men ◽  
Regular Partner ◽  
Sexual Position ◽  
Behavioural Surveillance ◽  
And Bisexual

Background Condom promotion remains a cornerstone of HIV/STI control, but must be informed by evidence of uptake and address disparities in use. This study sought to determine the prevalence of, and demographic, behavioural and relational factors associated with, condom use during insertive and receptive anal intercourse with casual partners among younger gay, bisexual and other men who have sex with men (YMSM) in New Zealand. Methods: The 2006–2011 national HIV behavioural surveillance data for YMSM aged 16–29 years was pooled. Separately for each sexual position, frequent (always/almost always) versus infrequent condom use was regressed onto explanatory variables using manual backward stepwise multivariable logistic regression analysis. Results: Three-quarters of YMSM reported frequent condom use during insertive (76.0%) and receptive (73.8%) anal intercourse. YMSM who were exclusively insertive were more likely to report frequent condom use than versatile YMSM. Factors positively associated with frequent condom use, irrespective of sexual position were: in-person versus web-based recruitment, testing HIV negative versus never testing or testing HIV positive, having no recent sex with women, reporting two to five versus one male sexual partner in the past 6 months, reporting no current regular partner, but if in a regular relationship, reporting a boyfriend-type versus fuckbuddy-type partner, and frequent versus infrequent regular partner condom use. Pacific ethnicity and less formal education were negatively associated with frequent condom use only during receptive anal intercourse. Conclusions: The findings from this study demonstrate that condom norms can be actively established and maintained among YMSM. Condom promotion efforts must increase YMSM’s capacity, agency and skills to negotiate condom use, especially for the receptive partner.

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