HIV Incidence Among Men With and Those Without Sexually Transmitted Rectal Infections: Estimates From Matching Against an HIV Case Registry

Pathela, Preeti; Braunstein, Sarah L.; Blank, Susan; Schillinger, Julia A.

doi:10.1093/cid/cit437

Cited by 134 publications

(102 citation statements)

References 22 publications

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“…After extensive control for confounding by behavioral risk with propensity score-weighted models, MSM diagnosed with rectal STI during study follow-up were more than 2.5 times as likely to acquire HIV as MSM not diagnosed with Previous studies have highlighted the importance of rectal STI in HIV acquisition in U.S. MSM, but these studies were conducted in STI clinic settings, which could bias toward a higher behavioral risk population with more symptomatic STIs. 26,27 In addition, these studies relied on passive case finding and did not observe incident STIs and HIV diagnoses prospectively as did our study. One longitudinal cohort study conducted in Australia also showed an association between a combined exposure of self-reported and study-diagnosed rectal STI and HIV; however, it is not clear if these results apply to a sample of black and white MSM in the United States with substantially higher rates of both STI and HIV.…”

Section: Discussionmentioning

confidence: 99%

The Effect of High Rates of Bacterial Sexually Transmitted Infections on HIV Incidence in a Cohort of Black and White Men Who Have Sex with Men in Atlanta, Georgia

Kelley

Vaughan

Luisi

et al. 2015

AIDS Research and Human Retroviruses

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Data reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95% CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95% CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs.

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Section: Discussionmentioning

confidence: 99%

The Effect of High Rates of Bacterial Sexually Transmitted Infections on HIV Incidence in a Cohort of Black and White Men Who Have Sex with Men in Atlanta, Georgia

Kelley

Vaughan

Luisi

et al. 2015

AIDS Research and Human Retroviruses

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“…This may be as a surrogate marker of sexual risk, or due to changes in local inflammation and immunity, enhancing susceptibility (93)(94)(95)(96). Infection of the urethra (and possibly rectum) may increase likelihood of HIV transmission in HIV-positive MSM (97), although interim data from the PARTNER study showed no transmissions from men with undetectable HIV viral loads, despite significant rates of incident bacterial STI (98).…”

Section: Chlamydia and Gonorrhoeamentioning

confidence: 99%

“…The presence of an acute STI, such as syphilis, chlamydia and gonorrhoea, is associated with increased HIV acquisition (228), the strongest association being with rectal infections (94,95,229). HIV incidence varied by the rate of incident syphilis, when controlled for known predictors of HIV in the iPrEx study of HIV PrEP (230).…”

Section: Sti and Hiv Testing 231 Recall Arrangements And Frequency mentioning

confidence: 99%

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

et al. 2018

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“…[44][45][46] Irrespective of antiretroviral therapy, urethral chlamydia or gonorrhoea can increase seminal HIV viral load and thus infectiousness among HIV-positive MSM. 47 Therefore, regular STI testing among HIV-positive MSM is likely to have public as well as individual health benefits.…”

Section: -32mentioning

confidence: 99%

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

et al. 2014

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Abstract.Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009-May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.

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HIV Incidence Among Men With and Those Without Sexually Transmitted Rectal Infections: Estimates From Matching Against an HIV Case Registry

Cited by 134 publications

References 22 publications

The Effect of High Rates of Bacterial Sexually Transmitted Infections on HIV Incidence in a Cohort of Black and White Men Who Have Sex with Men in Atlanta, Georgia

The Effect of High Rates of Bacterial Sexually Transmitted Infections on HIV Incidence in a Cohort of Black and White Men Who Have Sex with Men in Atlanta, Georgia

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

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