Since January 2011, LGV positivity in MSM consultations in Amsterdam has risen significantly. The great majority comprise anal LGV; inguinal LGV is rare. Anal LGV is asymptomatic in a quarter of cases. In all MSM with anal Ct infections LGV should be excluded, irrespective of symptoms or inflammatory signs.

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Urethral lymphogranuloma venereum (LGV) is not screened routinely. We found that in 341 men having sex with men with anorectal LGV, 7 (2.1%) had concurrent urethral LGV. Among 59 partners, 4 (6.8%) had urethral LGV infections. Urethral LGV is common, probably key in transmission, and missed in current routine LGV screening algorithms.

BackgroundChemsex (drug use to enhance sex) has emerged among men who have sex with men (MSM). Non-consensual sex (NCS) is hypothesised to occur frequently under the influence of chemsex, however data are scarce. In this cross-sectional study, it was aimed to assess whether NCS is associated with chemsex.MethodsWe offered a survey about chemsex in the past 6 months (crystal methamphetamine, mephedrone and/or gamma-hydroxybutyrate/gamma-butyrolacton use) and NCS (sexual experiences beyond one’s limits or unpleasant sexual experiences) in the past 5 years to Amsterdam-located gay dating platform users. Associations were assessed using χ² test, Fisher’s exact test and multivariable logistic regression.ResultsOf 891 participants, 30.6% (273 of 891) engaged in chemsex; 21.2% engaging and 16.7% not engaging in chemsex reported any NCS experiences (p=0.109).Among MSM who reported any NCS experiences, chemsex engagers reported being touched against one’s will less often compared with non-engagers (22.4% vs 39.8%; p=0.036). Yet, chemsex engagers reported passing out and not remembering what happened during drug use more often (41.4% vs 8.7%; p<0.001). The level of suffering from NCS experiences did not differ between chemsex engagers and non-engagers (p=0.539); and was rated by most participants with no suffering at all or low suffering (77.1%). In the multivariable regression analyses, chemsex engagement in the past 6 months was associated with NCS (adjusted OR 1.46; 95% CI 1.01 to 2.11).ConclusionsA substantial proportion of MSM (regardless of chemsex engagement) reported NCS in the past 5 years. In multivariate logistic regression analysis, chemsex engagement was associated with an NCS experience. Among participants who reported NCS, suffering related to NCS however, did not differ between chemsex engagers and non-engagers. Sexual healthcare professionals need to address chemsex and NCS during consultations involving MSM and refer men for specialised help if deemed necessary.

BackgroundGlobal data show that transgender people (TGP) are disproportionally affected by HIV and sexually transmitted infections (STIs); however, data are scarce for Western European countries. We assessed gender identities, sexual behaviour, HIV prevalence and STI positivity rates, and compared these outcomes between TGP who reported sex work and those who did not.MethodsWe retrospectively retrieved data from all TGP who were tested at the STI clinics of Amsterdam and The Hague, the Netherlands in 2017–2018. To identify one’s gender identity, a ‘two-step’ methodology was used assessing, first, the assigned gender at birth (assigned male at birth (AMAB)) or assigned female at birth), and second, clients were asked to select one gender identity that currently applies: (1) transgender man/transgender woman, (2) man and woman, (3) neither man nor woman, (4) other and (5) not known yet. HIV prevalence, bacterial STI (chlamydia, gonorrhoea and/or infectious syphilis) positivity rates and sexual behaviour were studied using descriptive statistics.ResultsTGP reported all five categories of gender identities. In total 273 transgender people assigned male at birth (TGP-AMAB) (83.0%) and 56 transgender people assigned female at birth (TGP-AFAB) (17.0%) attended the STI clinics. Of TGP-AMAB, 14,6% (39/267, 95% CI 10.6% to 19.4%) were HIV-positive, including two new diagnoses and bacterial STI positivity was 15.0% (40/267, 95% CI 10.9% to 19.8%). Among TGP-AFAB, bacterial STI positivity was 5.6% (3/54, 95% CI 1.2% to 15.4%) and none were HIV-positive. Sex work in the past 6 months was reported by 53.3% (137/257, 95% CI 47.0% to 59.5%) of TGP-AMAB and 6.1% (3/49, 95% CI 1.3% to 16.9%) of TGP-AFAB. HIV prevalence did not differ between sex workers and non-sex workers.ConclusionOf all TGP, the majority were TGP-AMAB of whom more than half engaged in sex work. HIV prevalence and STI positivity rates were substantial among TGP-AMAB and much lower among TGP-AFAB. Studies should be performed to provide insight into whether the larger population of TGP-AMAB and TGP-AFAB are at risk of HIV and STI.