BACKGROUND: Early detection and treatment of bacterial sexually transmitted infections has been advocated as an HIV prevention strategy. AIM: To inform screening guidelines, the incidence and risk factors for urethral and anal gonorrhoea and chlamydia were studied in a prospective cohort of community-based HIV negative homosexual men in Sydney, New South Wales, Australia. METHODS: All participants were offered annual screening for gonorrhoea and chlamydia (study-visit diagnoses) on urine and anal swabs using nucleic acid amplification. Participants also reported diagnoses of gonorrhoea and chlamydia made elsewhere between interviews (interval diagnoses). All diagnoses were summed to create a combined incidence rate, and detailed data on specific sexual practices with casual and regular partners were collected. RESULTS: Among 1427 men enrolled, the combined incidence rates were 3.49 and 2.96 per 100 person-years for urethral and anal gonorrhoea, respectively; and 7.43 and 4.98 per 100 person-years for urethral and anal chlamydia, respectively. Urethral infections were associated with unprotected anal intercourse (UAI) with HIV-positive partners (hazard ratio (HR) = 2.58, 95% CI 1.10 to 6.05 for urethral gonorrhoea) and with frequent insertive oral sex (p for trend 0.007 for urethral chlamydia). Anal infections were associated with receptive UAI (p for trend 0.001 for both anal gonorrhoea and chlamydia) and other receptive anal sexual practices. Stratified analyses showed the independence of the associations of insertive oral sex with urethral infections and of non-intercourse receptive anal practices with anal infections. CONCLUSION: Incident gonorrhoea and chlamydia were common. Risk behaviours for both urethral and anal infections were not restricted to UAI. Screening that includes tests for anal and urethral infections should be considered for all sexually active homosexual men, not just for those who report UAI.
BACKGROUND: Early detection and treatment of bacterial sexually transmitted infections has been advocated as an HIV prevention strategy. AIM: To inform screening guidelines, the incidence and risk factors for urethral and anal gonorrhoea and chlamydia were studied in a prospective cohort of community-based HIV negative homosexual men in Sydney, New South Wales, Australia. METHODS: All participants were offered annual screening for gonorrhoea and chlamydia (study-visit diagnoses) on urine and anal swabs using nucleic acid amplification. Participants also reported diagnoses of gonorrhoea and chlamydia made elsewhere between interviews (interval diagnoses). All diagnoses were summed to create a combined incidence rate, and detailed data on specific sexual practices with casual and regular partners were collected. RESULTS: Among 1427 men enrolled, the combined incidence rates were 3.49 and 2.96 per 100 person-years for urethral and anal gonorrhoea, respectively; and 7.43 and 4.98 per 100 person-years for urethral and anal chlamydia, respectively. Urethral infections were associated with unprotected anal intercourse (UAI) with HIV-positive partners (hazard ratio (HR) = 2.58, 95% CI 1.10 to 6.05 for urethral gonorrhoea) and with frequent insertive oral sex (p for trend 0.007 for urethral chlamydia). Anal infections were associated with receptive UAI (p for trend 0.001 for both anal gonorrhoea and chlamydia) and other receptive anal sexual practices. Stratified analyses showed the independence of the associations of insertive oral sex with urethral infections and of non-intercourse receptive anal practices with anal infections. CONCLUSION: Incident gonorrhoea and chlamydia were common. Risk behaviours for both urethral and anal infections were not restricted to UAI. Screening that includes tests for anal and urethral infections should be considered for all sexually active homosexual men, not just for those who report UAI.
Authors: Fengyi Jin; Garrett P Prestage; Limin Mao; Susan C Kippax; Catherine M Pell; Basil Donovan; David J Templeton; Janette Taylor; Adrian Mindel; John M Kaldor; Andrew E Grulich Journal: J Infect Dis Date: 2006-07-28 Impact factor: 5.226
Authors: R E Johnson; T A Green; J Schachter; R B Jones; E W Hook; C M Black; D H Martin; M E St Louis; W E Stamm Journal: J Clin Microbiol Date: 2000-12 Impact factor: 5.948
Authors: Kenneth H Mayer; Linda-Gail Bekker; Ron Stall; Andrew E Grulich; Grant Colfax; Javier R Lama Journal: Lancet Date: 2012-07-20 Impact factor: 79.321
Authors: Eric P F Chow; Sepehr N Tabrizi; Samuel Phillips; David Lee; Catriona S Bradshaw; Marcus Y Chen; Christopher K Fairley Journal: J Clin Microbiol Date: 2016-07-13 Impact factor: 5.948
Authors: Mark Richard Stenger; Stefan Baral; Shauna Stahlman; Dan Wohlfeiler; Jerusha E Barton; Thomas Peterman Journal: Sex Health Date: 2017-02 Impact factor: 2.706
Authors: Tiffany R Phillips; Christopher K Fairley; Kate Maddaford; Jennifer Danielewski; Jane S Hocking; David Lee; Deborah A Williamson; Gerald Murray; Fabian Kong; Vesna De Petra; Catriona S Bradshaw; Marcus Y Chen; Rebecca Wigan; Anthony Snow; Benjamin P Howden; Suzanne M Garland; Eric P F Chow Journal: J Clin Microbiol Date: 2019-12-23 Impact factor: 5.948
Authors: Kyle T Bernstein; Harrell Chesson; Robert D Kirkcaldy; Julia L Marcus; Thomas L Gift; Sevgi O Aral Journal: Sex Transm Dis Date: 2017-10 Impact factor: 2.830
Authors: Tiffany R Glynn; Don Operario; Madeline Montgomery; Alexi Almonte; Philip A Chan Journal: AIDS Patient Care STDS Date: 2017-05-22 Impact factor: 5.078
Authors: B P Mulhall; S T Wright; N De La Mata; D Allen; K Brown; B Dickson; M Grotowski; E Jackson; K Petoumenos; R Foster; T Read; D Russell; D J Smith; D J Templeton; C K Fairley; M G Law Journal: HIV Med Date: 2016-03-28 Impact factor: 3.180
Authors: Cara E Rice; Courtney Maierhofer; Karen S Fields; Melissa Ervin; Stephanie T Lanza; Abigail Norris Turner Journal: J Sex Med Date: 2016-02-04 Impact factor: 3.802