Lao-Tzu Allan-Blitz1, Timothy W Menza, Vanessa Cummings, Charlotte A Gaydos, Leo Wilton, Kenneth H Mayer. 1. 1Division of Global Health Equity: Department of Medicine, Brigham and Women's Hospital, Boston, MA 2Department of Medicine, Boston Children's Hospital, Boston, MA 3Department of Medicine, Division of Infectious Diseases, Oregon Health and Science University, Portland, OR 4Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD 5Department of Medicine, Johns Hopkins University, Baltimore, MD 6Department of Human Development, State University of New York at Binghamton, Binghamton, NY 7Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa 8The Fenway Institute of Fenway Health, Boston, MA 9Division of Infectious Diseases: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 10Department of Medicine, Harvard Medical School, Boston, MA.
Abstract
BACKGROUND: Black men who have sex with men are at disproportionate risk for sexually transmitted infections (STI). Understanding the drivers of those disparities can lead to culturally-tailored interventions. We aimed to characterize the incidence and correlates of STI among Black individuals from HPTN 061, a multi-city cohort study conducted from 2009-2011 in the US. METHODS: We used Cox proportional hazards regression to estimate adjusted hazard ratios (aHR) accounting for within participant correlation over multiple follow-up visits (enrollment, 6- and 12-month). We examined correlates of incident rectal and urethral STI as well as incident syphilis. RESULTS: Among 1522 individuals, the incidence of urethral and rectal Neisseria gonorrhoeae infection was 1.0 (95%CI: 0.6, 1.8) and 4.6 (95%CI: 3.5, 6.3) cases per 100 person-years, respectively. The incidence of urethral and rectal Chlamydia trachomatis infection was 2.5 (95%CI: 1.7, 3.6) and 2.5 (95%CI: 1.7, 3.7) cases per 100 person-years, respectively. The incidence of syphilis was 3.6 (95% CI 2.7-4.9) cases per 100 person-years. Younger age was associated with increased odds of incident urethral (aHR=5.1; 95% CI 2.3-11.1) and rectal (aHR=2.6; 95% CI 1.6-4.3) STI. Diagnosis of a rectal STI at baseline (aHR=2.3; 95% CI 1.1-4.0), use of saliva as lubricant (aHR=1.7; 95% CI 1.1-2.8) were associated with incident rectal STI. Diagnosis of syphilis at baseline was associated with incident syphilis during follow-up (aHR 5.6; 95% CI 2.5-12.2). CONCLUSIONS: Younger participants had the highest STI incidence. Use of saliva as lubricant may be a driver of rectal infection, which deserves further study.
BACKGROUND: Black men who have sex with men are at disproportionate risk for sexually transmitted infections (STI). Understanding the drivers of those disparities can lead to culturally-tailored interventions. We aimed to characterize the incidence and correlates of STI among Black individuals from HPTN 061, a multi-city cohort study conducted from 2009-2011 in the US. METHODS: We used Cox proportional hazards regression to estimate adjusted hazard ratios (aHR) accounting for within participant correlation over multiple follow-up visits (enrollment, 6- and 12-month). We examined correlates of incident rectal and urethral STI as well as incident syphilis. RESULTS: Among 1522 individuals, the incidence of urethral and rectal Neisseria gonorrhoeae infection was 1.0 (95%CI: 0.6, 1.8) and 4.6 (95%CI: 3.5, 6.3) cases per 100 person-years, respectively. The incidence of urethral and rectal Chlamydia trachomatis infection was 2.5 (95%CI: 1.7, 3.6) and 2.5 (95%CI: 1.7, 3.7) cases per 100 person-years, respectively. The incidence of syphilis was 3.6 (95% CI 2.7-4.9) cases per 100 person-years. Younger age was associated with increased odds of incident urethral (aHR=5.1; 95% CI 2.3-11.1) and rectal (aHR=2.6; 95% CI 1.6-4.3) STI. Diagnosis of a rectal STI at baseline (aHR=2.3; 95% CI 1.1-4.0), use of saliva as lubricant (aHR=1.7; 95% CI 1.1-2.8) were associated with incident rectal STI. Diagnosis of syphilis at baseline was associated with incident syphilis during follow-up (aHR 5.6; 95% CI 2.5-12.2). CONCLUSIONS: Younger participants had the highest STI incidence. Use of saliva as lubricant may be a driver of rectal infection, which deserves further study.
Authors: Lao-Tzu Allan-Blitz; Timothy W Menza; Vanessa Cummings; Charlotte A Gaydos; Leo Wilton; Kenneth H Mayer Journal: Sex Transm Dis Date: 2022-07-01 Impact factor: 3.868
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Authors: Maria Rabia Khan; Russell Brewer; Jasmyn Abrams; Medha Mazumdar; Joy D Scheidell; Jonathan Feelemyer; Typhanye V Dyer; Rodman E Turpin; Christopher Hucks-Ortiz; Charlotte A Gaydos; MacRegga Severe; Natalia M Irvine; Jay S Kaufman; Charles M Cleland; Kenneth H Mayer Journal: Sex Transm Dis Date: 2022-04-01 Impact factor: 3.868