Characteristics Associated With Urethral and Rectal Gonorrhea and Chlamydia Diagnoses in a US National Sample of Gay and Bisexual Men

Abstract

Background Gay and bisexual men (GBM) are at elevated risk for gonorrhea and chlamydia trachomatis (GC/CT). Rectal GC/CT symptoms may be less obvious than urethral, increasing opportunities for undiagnosed rectal GC/CT. Method A U.S. national sample of 1,071 GBM completed urethral and rectal GC/CT testing and an online survey. Results In total, 6.2% were GC/CT positive (5.3% rectal, 1.7% urethral). We calculated adjusted (for education, race, age, relationship status, having health insurance, and income) odds ratios for factors associated with rectal and urethral GC/CT diagnoses. Age was inversely associated with urethral and rectal GC/CT. Compared to White men, Latinos had significantly greater odds of rectal GC/CT. Among men who reported anal sex, those reporting only insertive sex had lower odds of rectal GC/CT than men who reported both insertive and receptive. There was a positive association between rectal GC/CT and number of male partners (<12 months), the number of anal receptive acts, receptive condomless anal sex (CAS) acts, and insertive CAS acts. Compared to those who had engaged in both insertive and receptive anal sex, those who engaged in only receptive anal sex had lower odds of urethral GC/CT. The number of male partners (<12 months) was associated with increased odds of urethral GC/CT. Conclusion Rectal GC/CT was more common than urethral and associated with some demographic and behavioral characteristics. Our finding that insertive CAS acts was associated with rectal GC/CT highlights that providers should screen patients for GC/CT via a full range of transmission routes, lest GC/CT go undiagnosed.

Epidemiological Analysis of Symptomatic Gonococcal Infection among Male Patients attending STD Clinic

“…Among men who reported anal sex, those reporting only insertive sex had lower incidence of gonorrhoea than did men who reported both insertive and receptive which was observed by Grov et al [8]. 2% incidence of rectal and pharyngeal gonorrhoea was observed in our study, which is lower than that reported by Mathew et al [9] .…”

Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a National Cohort of Gay and Bisexual Men in the United States

“…The sample was recruited to reflect census data on same-sex households in terms of racial and ethnic composition, age, and geographic distribution—the geographic distribution of the entire cohort at baseline can be found in Figure 2. Following consent, as part of the baseline assessment, participants completed an online survey, at-home self-administered rapid HIV testing, and sent in self-collected samples for urethral and rectal chlamydia/gonorrhea; all those enrolled had a confirmed HIV-negative test result [26]. These procedures are repeated every 12 months; data for this manuscript were taken from the 12-month follow-up.…”

Distinguishing hypothetical willingness from behavioral intentions to initiate HIV pre-exposure prophylaxis (PrEP): Findings from a large cohort of gay and bisexual men in the U.S.

“…One Thousand Strong is a longitudinal study prospectively following a national cohort of GBM across the U.S. for a period of 3 years, with many of the details described elsewhere (Grov et al, 2016a; Grov et al, 2016b). Participants were identified through a Community Marketing and Insights, Inc. (http://communitymarketinginc.com/) panel of over 22,000 GBM throughout the United States.…”