Sexually transmitted infection screening and diagnosis among adolescent men who have sex with men, three US cities, 2015

2019 ◽  
Vol 31 (1) ◽  
pp. 53-61
Author(s):  
Qian An ◽  
Kyle T Bernstein ◽  
Alexandra B Balaji ◽  
Cyprian Wejnert ◽  
Keyword(s):  
Transmitted Infection ◽  
Sexually Transmitted ◽  
National Hiv Behavioral Surveillance ◽  
Increased Risk ◽  
Characteristics Analysis ◽  
Young Msm ◽  
Sex With Men ◽  
Stis And Hiv ◽  
Associated Risk Factors ◽  
Screening And Diagnosis

Adolescent men who have sex with men (MSM) are at increased risk for sexually transmitted infections (STIs) and HIV; however, data documenting STI screening, STI burden, and associated risk factors for STIs are extremely limited. Using 2015 data from the National HIV Behavioral Surveillance among Young MSM, we examined self-reported STI screening and STI diagnosis of chlamydia, gonorrhea, or syphilis among sexually active adolescent MSM by selected characteristics. Analysis of STI diagnosis was limited to participants who reported an STI screening. Differences in STI screening and STI diagnosis and factors associated with screening and diagnosis were examined using bivariate and multivariable binomial regression models. Less than half of adolescent MSM reported having ever been screened for an STI. Among these, more than a quarter reported having ever been diagnosed with chlamydia, gonorrhea, or syphilis. STI screening was associated with visiting a healthcare provider in the past 12 months and having ever been tested for HIV. Having ever had an STI diagnosis was associated with the participant age of 18 years and having sex before 13 years old. Among adolescent MSM, STI screening was suboptimal and STI burden was significant. STI intervention and prevention programs are urgently needed to promote STI awareness, timely screening, and early diagnosis to interrupt transmission among this vulnerable population.

scholarly journals Sexual behaviours and sexually transmitted infection outcomes in a cohort of HIV-negative men who have sex with men attending sexual health clinics in England

2018 ◽  
Vol 29 (14) ◽  
pp. 1407-1416 ◽  
Author(s):  
S Desai ◽  
F Burns ◽  
G Schembri ◽  
D Williams ◽  
A Sullivan ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Health ◽  
Receptive Anal Intercourse ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Sex With Men ◽  
Clinical Records ◽  
Hiv Negative

Men who have sex with men (MSM) attending sexual health (SH) clinics are at high risk for HIV acquisition and are disproportionately affected by sexually transmitted infections (STIs). We collected standardised behavioural data from MSM attending clinics to characterise sexual behaviours and identify predictors for HIV and STIs. In 2012–2013, HIV-negative MSM attending five SH clinics in England reported sexual behaviours in the previous three months via a self-administered questionnaire. Behaviours were linked to the individual’s clinical records using national surveillance. The prevalence and incidence of bacterial STIs (gonorrhoea, Chlamydia, lymphogranuloma venereum and syphilis) and incidence of HIV were calculated. Adjusted odds ratios and hazard ratios with 95% confidence interval (CI) were reported for significant predictors. Of 1278 HIV-negative MSM, 54% were of white ethnicity and UK-born and 43% were 25–34 years old. Almost all men reported at least one partner in the last three months. Half reported condomless anal sex and 36% condomless receptive anal intercourse (CRAI). Incidence of bacterial STIs was 46/100 (95%CI 39–54) person years (py) and of HIV was 3.1/100 (95%CI 1.7–5.6) py. A STI at baseline and CRAI with increasing numbers of partners were associated with both incident infections. In this cohort of MSM high-risk behaviours and STIs were prevalent. Engagement in CRAI increased the likelihood of subsequent infection, while men diagnosed with a bacterial STI were at increased risk of a future STI. Clinical and behavioural risk assessments to determine an individual’s risk of infection could allow a more nuanced prevention approach that has greater success in reducing transmission.

scholarly journals Prevalence of Human Papillomavirus, Human Immunodeficiency Virus, and Other Sexually Transmitted Infections Among Men Who Have Sex With Men in Togo: A National Cross-sectional Survey

2018 ◽  
Vol 69 (6) ◽  
pp. 1019-1026 ◽  
Author(s):  
Valentine Marie Ferré ◽  
Fifonsi A Gbeasor-Komlanvi ◽  
Gilles Collin ◽  
Anoumou Claver Dagnra ◽  
Quentin Le Hingrat ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Human Papillomavirus ◽  
Sub Saharan Africa ◽  
National Study ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
Sex With Men

Abstract Background Sub-Saharan Africa is a region of both high human immunodeficiency virus (HIV) and anal cancer incidence. We conducted the first national study in Togo to assess human papillomavirus (HPV), HIV, and other sexually transmitted infection (STI) prevalence among men who have sex with men (MSM). Methods A multicentric cross-sectional study was conducted among MSM recruited in 4 Togolese cities. Anal swabs were collected to test HPV, herpes simplex virus (HSV), and 7 STIs. Results Among the 207 MSM, HIV and high-risk HPV (hrHPV) overall prevalence were 26.1% and 44.9%, respectively. The most common hrHPV types were HPV-35 (15.0%) and HPV-16 (13.0%). Prevalence of hrHPV and multiple HPV infections were higher among HIV-infected than among HIV-uninfected MSM (85.2% vs 30.7%, P < 10–5 and 85.2% vs 28.7%, P < 10–5, respectively). Other STIs, except hepatitis B virus, were also more prevalent among HIV-infected MSM (Neisseria gonorrhoeae, P = .03; Mycoplasma genitalium, P = .04; HSV-2, P = .001; and a trend for Chlamydia trachomatis, P = .06). In multivariate analysis (adjusted odds ratio [95% confidence interval]), HIV (10.1 [4.0–25.6]), living in Lomé (2.8 [1.1–7.1]), HSV-2 excretion (26.7 [2.9–244.3]), C. trachomatis (11.7 [2.3–58.9]), and M. genitalium infection (9.6 [3.1–29.9]) were associated with increased risk of hrHPV infection. Conclusions We report a high burden of anal STIs with an unusual hrHPV type distribution among MSM, highlighting the critical need of implementation of a national strategy regarding prevention of STIs and vaccination against HPV.

scholarly journals LB11. Rapid Rise in Decreased Susceptibility to Azithromycin among Shigella Isolates in the United States: A Look at National Surveillance Data, 2011–2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S763-S763 ◽  
Author(s):  
Cindy Friedman ◽  
Ian Plumb ◽  
Jared Reynolds ◽  
Jessica Chen ◽  
Kaitlin Tagg ◽  
...  
Keyword(s):  
United States ◽  
Resistance Mechanism ◽  
Fold Increase ◽  
The United States ◽  
Adult Males ◽  
Rapid Rise ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Sex With Men

Abstract Background Shigella spp. cause ~500,000 illnesses in the United States annually. Antibiotics are recommended for immunocompromised patients and shorten the duration of illness, thus limiting spread. First-line treatments include ciprofloxacin (CIP) and azithromycin (AZM). CIP resistance is a growing problem in the United States; decreased susceptibility to AZM (DSA) has been reported globally, particularly among men who have sex with men (MSM). We reviewed National Antimicrobial Resistance Monitoring System (NARMS) data to determine DSA trends among Shigella isolates in the United States. Methods Health departments nationwide forward every 20th Shigella isolate to CDC NARMS for antimicrobial susceptibility testing using broth microdilution. We defined CIP resistance using CLSI clinical breakpoints and DSA using epidemiological cutoff values where available. We performed whole genome sequencing on isolates from 2016 and screened the sequences for resistance determinants using ResFinder 3.0. Results To date, we have tested 3,044 Shigella isolates collected during 2011–2017. Overall, 264 isolates (9%) had DSA, increasing from 3% in 2011 to 23% in 2017; 41 (16%) were also CIP resistant. The odds of DSA increased by 1.5 (95% confidence interval [CI] 1.4–1.6) annually. DSA was more common among adult males (OR 21.2, CI 14.9–30.3), in isolates from the West census region (OR 2.4, CI 1.8–3.2), and in S. flexneri (OR 8.2, CI 6.3–10.7). Of 543 sequenced isolates, 52 (10%) had DSA; of these, 31 (60%) contained both mph(A) and erm(B) genes, 17 (33%) contained mph(A) only, and 4 (8%) had no identified macrolide-resistance mechanism. Conclusions In 2017, nearly 1 in 4 Shigella isolates tested had DSA, a 7-fold increase since 2011. This rapid rise in DSA parallels that seen in other countries, where resistance to other clinically relevant drugs is high and macrolides are no longer useful as empiric treatment. The increased risk of DSA in adult males is consistent with previous reports of DSA Shigella in MSM. The resistance genes observed are typically plasmid-mediated and can be transferred to other bacteria. Public health strategies to mitigate the spread of resistant Shigella should include antibiotic stewardship and novel approaches for sexually transmitted infection prevention in MSM. Disclosures All authors: No reported disclosures.

High subsequent and recurrent sexually transmitted infection prevalence among newly diagnosed HIV-positive Thai men who have sex with men and transgender women in the Test and Treat cohort

2018 ◽  
Vol 30 (2) ◽  
pp. 140-146 ◽  
Author(s):  
Akarin Hiransuthikul ◽  
Supanit Pattanachaiwit ◽  
Nipat Teeratakulpisarn ◽  
Parinya Chamnan ◽  
Panita Pathipvanich ◽  
...  
Keyword(s):  
Transgender Women ◽  
Hiv Positive ◽  
Infection Prevalence ◽  
Anatomical Site ◽  
Newly Diagnosed ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Test And Treat ◽  
Increased Risk ◽  
Sex With Men

We determined subsequent and recurrent sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender women (TGW) in the Test and Treat cohort. Thai MSM and TGW adults with previously unknown HIV status were enrolled and tested for HIV. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and syphilis were tested at baseline, month 12, and month 24 to identify subsequent STIs (any STIs diagnosed after baseline) and recurrent STIs (any subsequent STIs diagnosed among those with positive baseline STIs). Among 448 participants, 17.8% were HIV-positive, the prevalence of subsequent STIs and recurrent STIs was 42% (HIV-positive versus HIV-negative: 66.3% versus 36.7%, p < 0.001) and 62.3% (81% versus 52.5%, p < 0.001), respectively. Common subsequent STIs by anatomical site were rectal CT infection (21.7%), rectal NG infection (13.8%), pharyngeal NG infection (13.1%), and syphilis (11.9%). HIV-positive status was associated with both subsequent STIs (adjusted hazard ratio [aHR] 2.38; 95%CI 1.64–3.45, p < 0.001) and recurrent STIs (aHR 1.83; 95%CI 1.16–2.87, p = 0.01). The results show that newly diagnosed HIV-positive MSM and TGW were at increased risk of STIs despite being in the healthcare system. STI educational counseling is necessary to improve STI outcomes among MSM and TGW in both HIV prevention and treatment programs.

scholarly journals Prevalence of gonorrhea and chlamydia in a community clinic for Men who Have Sex with Men in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Ribeiro ◽  
D de Sousa ◽  
D Medina ◽  
R Castro ◽  
A Lopes ◽  
...  
Keyword(s):  
High Frequency ◽  
Cross Sectional Study ◽  
Sexual Partners ◽  
Foreign Born ◽  
Inhaled Drugs ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Sex With Men ◽  
Associated Risk Factors

Abstract Background Men who have sex with men (MSM) are at greater risk for sexually transmitted infections (STIs). Data on MSM chlamydia and gonorrhea prevalence estimates and associated risk factors is scarce. To our knowledge, this is the first study to describe the prevalence and the determinants of both chlamydia and gonorrhea infections in MSM in Portugal. Methods We conducted a cross-sectional study using data from 1,832 visits to CheckpointLX, a community-based center for screening blood-borne viruses and other STIs in MSM. Results Overall prevalence of chlamydia or gonorrhea in our sample was 16.05%, with 14.23% coinfection and 40.73% asymptomatic presentation among those testing positive. Anorectal infection was most common for chlamydia (67.26%), followed by urethral (24.78%) and oral (19.47%) infection. Oral infection was most common for gonorrhea (55.63%), followed by anal (51.25%) and urethral (17.50%) infection. In multivariate analyses, young age (U = 94684, p = 0.014), being foreign-born (χ2=11.724, p = 0.003), reporting STI symptoms (χ2=5.316, p = 0.021), inhaled drug use (χ2=4.278, p = 0.039) and having a higher number of concurrent (χ2=18.769, p &lt; 0.001) or total (χ2=5.988, p = 0.050) sexual partners were each associated with higher rates of chlamydia or gonorrhea infection. Conclusions Young and migrant MSM are a vulnerable population to STIs, as are those who use inhaled drugs and those with a higher number of concurrent or total sexual partners. Although Portugal has no guidelines on chlamydia and gonorrhea screening, our results point towards a need for greater awareness about the importance of high frequency screening for those at increased risk (i.e. every 3 to 6 months). Key messages Higher prevalence was found in young and migrant MSM, those with higher number of concurrent or total sexual partners, and those who use inhaled drugs. There is a need for greater awareness about the importance of high frequency STI screening for MSM at increased risk.

Trojan Horse: An Analysis of Targeted Advertising to Reduce Sexually Transmitted Diseases Among YMSM

2021 ◽  
pp. 109019812110003
Author(s):  
Ayla Tolosa-Kline ◽  
Elad Yom-Tov ◽  
Caitlin Hoffman ◽  
Cherie Walker-Baban ◽  
Felicia M.T. Lewis
Keyword(s):  
Conversion Rate ◽  
Public Health Intervention ◽  
Unprotected Sex ◽  
Postal Service ◽  
Transmitted Infection ◽  
Data Set ◽  
Sexually Transmitted ◽  
Test Kit ◽  
Young Msm ◽  
Sex With Men

Background Men who have sex with men (MSM) increasingly use internet-based websites and geospatial apps to seek sex. Though these platforms may be useful for public health intervention, evaluations of such interventions are rare. We sought to evaluate the online behavior of young MSM of color in Philadelphia and the effectiveness of using ads to link them to DoYouPhilly.org, where users can order free condoms, lubricant, and sexually transmitted infection test kits delivered via the U.S. postal service. Method Data collection and analyses were conducted in two phases. First, we performed keyword research and analyzed web browser logs using a proprietary data set owned by Microsoft. Subsequently, we ran a Google Ads campaign using the keywords identified in the preliminary phase, and directed targeted users to the DoYouPhilly.org condom or test kit ordering pages. Results were analyzed using MATLAB 2018. Results Test kit advertisements received 5,628 impressions, 157 clicks, and 18 unique conversions. The condom advertisements received 128,007 impressions, 2,583 clicks, and 303 unique conversions. Correlation between the click-through rate and the conversion rate per keyword was ρ = −.35 ( P = .0096) and per advertisement was ρ = .40 ( P = .14). Keywords that directly related to condoms were most effective for condom ordering (42% conversion rate vs. ≤2% for other classes), while keywords emphasizing the adverse effects of unprotected sex were most effective in test kit ordering (91% conversion rate vs. 13% and 12% for other classes). Conclusions Online advertisements seemed to affect real-world sexual health behavior, as measured by orders of condoms and test kits, among a group of young MSM living in the same community.

scholarly journals Hepatitis E virus (HEV): seroprevalence and HEV RNA detection in subjects attending a sexually transmitted infection clinic in Brussels, Belgium

2017 ◽  
Vol 145 (16) ◽  
pp. 3370-3374 ◽  
Author(s):  
N. DAUBY ◽  
V. SUIN ◽  
M. JACQUES ◽  
M. ABADY ◽  
S. VAN DEN WIJNGAERT ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexually Transmitted Infection Clinic ◽  
Hiv Test ◽  
Increased Risk ◽  
Sex With Men ◽  
Infection Clinic

SUMMARYMen who have sex with men (MSM) have an increased incidence of pathogens transmitted by the oro-fecal route. Hepatitis E virus (HEV) is an emerging cause of acute hepatitis and fecal shedding is observed during primary infection. We investigated whether MSM are at increased risk of HEV infection. Subjects who attended a sexually transmitted infection clinic in Brussels and had an HIV test performed between 1 June 2014 and 15 January 2016 were identified. A total of 576 samples were retrospectively screened for both total HEV IgG and HEV RNA. Samples positive for IgG were tested for IgM. MSM proportion was 31·1% (179/576). Overall HEV IgG prevalence was 9·03% (52/576) and was identical in MSM and heterosexual subjects. Among the IgG positive samples, 2/52 (3·84%) samples (both women) were positive for anti-HEV IgM. No sample was positive for HEV RNA. Age over 35 was the only risk factor significantly associated with HEV seropositivity (OR 2·07; 95% CI 1·16–3·67). In conclusion, MSM were not found to have an increased prevalence of HEV as previously reported in other European countries suggesting distinct dynamics of HEV infection in this group across Europe and increased age was associated with a higher risk of seropositivity.

scholarly journals Prevalence of gonorrhea and chlamydia in a community clinic for men who have sex with men in Lisbon, Portugal

2019 ◽  
Vol 30 (10) ◽  
pp. 951-959 ◽  
Author(s):  
Sofia Ribeiro ◽  
Diogo de Sousa ◽  
Diogo Medina ◽  
Rita Castro ◽  
Ângela Lopes ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sexual Partners ◽  
Foreign Born ◽  
Inhaled Drugs ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Sex With Men ◽  
Using Data ◽  
Associated Risk Factors

Men who have sex with men (MSM) are at greater risk for sexually transmitted infections (STIs). Data on MSM chlamydia and gonorrhea prevalence estimates and associated risk factors are scarce. To our knowledge, this is the first study to describe the prevalence and the determinants of both chlamydia and gonorrhea infections in MSM in Portugal. We conducted a cross-sectional study using data from 1832 visits to CheckpointLX, a community-based center for screening blood-borne viruses and other STIs in MSM. Overall prevalence of chlamydia or gonorrhea in our sample was 16.05%, with 14.23% coinfection and 40.73% asymptomatic presentation among those testing positive. Anorectal infection was most common for chlamydia (67.26%), followed by urethral (24.78%) and oral (19.47%) infection. Oral infection was most common for gonorrhea (55.63%), followed by anal (51.25%) and urethral (17.50%) infection. In multivariate analyses, young age ( U = 94684, p = 0.014), being foreign-born (χ2 = 11.724, p = 0.003), reporting STI symptoms (χ2 = 5.316, p = 0.021), inhaled drug use (χ2 = 4.278, p = 0.039) and having a higher number of concurrent (χ2 = 18.769, p < 0.001) or total (χ2 = 5.988, p = 0.050) sexual partners were each associated with higher rates of chlamydia or gonorrhea infection. Young and migrant MSM are a vulnerable population to STIs, as are those who use inhaled drugs and those with a higher number of concurrent or total sexual partners. Although Portugal has no guidelines on chlamydia and gonorrhea screening, our results point toward a need for greater awareness about the importance of high-frequency screening for those at increased risk (i.e., every three to six months).

A comparison of HIV-risk behaviors between young black cisgender men who have sex with men and young black transgender women who have sex with men

2018 ◽  
Vol 29 (7) ◽  
pp. 665-672 ◽  
Author(s):  
Richard A Crosby ◽  
Laura F Salazar ◽  
Brandon Hill ◽  
Leandro Mena
Keyword(s):  
Oral Sex ◽  
Computer Assisted ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Exchange Sex ◽  
Sexually Transmitted ◽  
Multiple Risk Factors ◽  
The Usa ◽  
Sex With Men ◽  
Stis And Hiv

This study compared sexually transmitted infection (STI)-associated risks between young Black cisgender men who have sex with men (YBMSM) and young Black transwomen who have sex with men (YBTWSM). Comparisons pertained to: (1) prevalence of infections; (2) sexual risk; (3) partner-related risks; and (4) socioeconomic marginalization. YBMSM (n = 577) and YBTWSM (n = 32) were recruited from an STI clinic in the USA. Volunteers completed a computer-assisted self-interview and medical records were abstracted for STI/HIV information. Significantly greater prevalence of pharyngeal Chlamydia ( P < .001) and pharyngeal gonorrhea ( P = .04) occurred among YBTWSM; however, both associations were moderated and only significant for HIV-uninfected volunteers. YBTWSM had more oral sex partners and more frequent engagement in oral sex. The number of new sex partners for anal receptive sex was greater in YBTWSM. YBTWSM were more likely to exchange sex for money/drugs ( P < .001), have sex with men recently in prison ( P < .001), who were “anonymous” ( P = .004), or who were “one night stands” ( P < .001). YBTWSM were more likely to depend on sex partners for money food, etc. ( P < .001), to miss meals due to lack of money ( P = .01), and to report having ever being incarcerated ( P = .009). Compared to cisgender YBMSM, YBTWSM experience multiple risk factors relative to the acquisition/transmission of STIs and HIV.

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