Incidence and risk factors associated with chlamydia in men who have sex with men: a cohort analysis of Victorian Primary Care Network for Sentinel Surveillance data

Wilkinson, Anna L.; El-Hayek, Carol; Fairley, Christopher K.; Leslie, David; Roth, Norm; Tee, Ban Kiem; Hellard, Margaret; Stoové, Mark

doi:10.1136/sextrans-2011-050270

Cited by 27 publications

(17 citation statements)

References 26 publications

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“…Overall, the incidence of any anal HPV infection (21.3/100 person-years) and of oncogenic anal HPV infection (13.3/100 person-years) was greater than the reported incidence of other sexually transmitted infections (STIs) among HIV-positive MSM [18–20]. Rates of infection with individual anal HPV types were similar to the increased rates of other STIs commonly seen among MSM.…”

Section: Discussionmentioning

confidence: 82%

Incidence of and risk factors for type-specific anal human papillomavirus infection among HIV-positive MSM

Hernandez

Efird²,

Holly

et al. 2014

Aids

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Objective HIV-positive MSM are at increased risk of anal human papillomavirus (HPV) infection compared with men in the general population, and little is known about the natural history of anal HPV infection in this population. The objective of this study was to determine the incidence of and risk factors for anal type-specific HPV infection. Design Prospective cohort study. Methods HIV-positive MSM were evaluated for anal HPV DNA, lifestyle factors, and sexual risk behaviors every 6 months for at least 2 years. Results The overall incidence rate of detectable type-specific anal HPV infection was 21.3 per 100 person-years [95% confidence interval (CI) 17.7–25.4] and was 13.3/100 person-years (10.5–16.6) for oncogenic HPV types. The most common incident infections were HPV 18 (3.7/100 person-years) and HPV 16 (3.5/100 person-years). An increased number of recent partners with whom the participant was the receptive partner [odds ratio (OR) 2.9 (1.6–5.1) 8+ partners vs. 0–1], an increased number of new partners in which the participant was the receptive partner [OR 1.03 (1.01–1.1) per partner], an increased number of new oral–anal contact partners in which the participant was the receptive partner [OR 1.1 (1.03–1.1) per partner], and the frequency of receptive anal intercourse [OR 1.1 (1.03–1.1) per act] all significantly increased the odds of incident HPV infection (P ≤ 0.05). Conclusion HIV-positive MSM have a high incidence of oncogenic anal HPV infection. Recent receptive anal sexual behaviors, including receptive anal intercourse and receptive oral–anal contact, are the most important risk factors for incident anal HPV infection.

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Section: Discussionmentioning

confidence: 82%

Incidence of and risk factors for type-specific anal human papillomavirus infection among HIV-positive MSM

Hernandez

Efird²,

Holly

et al. 2014

Aids

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“…Men tested more often consistently when belonging to groups associated with an increased, long-term risk for STI; that is, being HIV positive, 16 18 having a low education level, 16 having a history of STI or having had more than 10 partners in the past six months. 17 22 We argue that due to this increased risk these MSM are more motivated to visit the STI clinic consistently compared with MSM practising lower risk behaviour. However, it is also possible that this is a consequence of STI clinic practices as men who are at higher sexual risk might be more often encouraged to test consistently.…”

Section: Discussionmentioning

confidence: 89%

“…Hence, we used HIV status, low education level and number of sex partners in the previous six months as proxies for sexual (high) risk behaviour. [16][17][18] Furthermore, there were many missing values for SES and education level, but loss of data was restricted by including missing values in the analyses as a separate category.…”

Section: Discussionmentioning

confidence: 99%

Frequency and determinants of consistent STI/HIV testing among men who have sex with men testing at STI outpatient clinics in the Netherlands: a longitudinal study

et al. 2017

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ObjectivesMen who have sex with men (MSM) are at highest risk for STIs and HIV infections in the Netherlands. However, official guidelines on STI testing among MSM are lacking. They are advised to test for STIs at least every six months, but their testing behaviour is not well known. This study aimed to get insight into the proportion and determinants of consistent 6-monthly STI testing among MSM testing at STI outpatient clinics in the Netherlands.MethodsThis study included longitudinal surveillance data of STI consultations among MSM from all 26 STI outpatient clinics in the Netherlands between 1 June 2014 and 31 December 2015. Multinomial logistic regression analysis was used to identify determinants of consistent 6-monthly testing compared with single testing and inconsistent testing. Determinants of time between consultations among men with multiple consultations were analysed using a Cox Prentice-Williams-Peterson gap-time model.ResultsA total of 34 605 STI consultations of 18 634 MSM were included. 8966 (48.1%) men had more than one consultation, and 3516 (18.9%) men tested consistently 6-monthly. Indicators of high sexual risk behaviour, including having a history of STI, being HIV positive and having more than 10 sex partners, were positively associated with both being a consistent tester and returning to the STI clinic sooner. Men who were notified by a partner or who reported STI symptoms were also more likely to return to the STI clinic sooner, but were less likely to be consistent testers, identifying a group of event-driven testers.ConclusionsThe proportion of consistent 6-monthly testers among MSM visiting Dutch STI outpatient clinics was low. Testing behaviour was associated with sexual risk behaviour, but exact motives to test consistently remain unclear. Evidence-based testing guidelines are needed to achieve optimal reductions in STI transmission in the future.

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“…A high prevalence of rectal C trachomatis infection in patients who have had recent receptive anal intercourse has been reported in both women 18 and men. 19 Diagnosis and treatment is crucial in such cases to control the spread of infection and reduce the risk of HIV infection in MSM. 20 Both doxycycline and azithromycin have proven effective in treating chlamydia, but the former is considered superior for the treatment of rectal infections.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Patients With Chlamydia trachomatis Genital Infection in an STD Clinic

Repiso‐Jiménez

Fernández-Morano

Rivas‐Ruiz

et al. 2014

Actas Dermo-Sifiliográficas (English Edition)

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Background and objectives: Chlamydia trachomatis genital infection is common in our setting and early treatment can prevent complications. The aim of this study was to report on patients diagnosed with C trachomatis genital infection in a sexually transmitted disease (STD) clinic. Material and methods: This was a descriptive, cross-sectional, observational study of patients diagnosed with C trachomatis infection between 2010 and 2011. We recorded demographic data and information on sexual habits, concomitant sexually transmitted infections (STIs), and various aspects of treatment. Results: In total, 12.3% of the samples analyzed were positive for C trachomatis genital infection. Sixty-two patients (43 men) with a mean age of 31 years were studied; 75% were heterosexual and 87% had had a sexual partner in the previous 2 months. Condom use was inconsistent in 81%, 79%, and 65% of patients who practiced vaginal, oral, and anal sex, respectively. Thirteen percent of the patients had symptoms and anogenital warts were the most common associated STI. The most widely used treatment was doxycycline. Conclusions: A high prevalence of genital C trachomatis infection was detected in our STD clinic, and the majority of cases were found in young men. We observed a high rate of asymptomatic infection in patients who do not engage in high-risk sexual behavior and who had come to the clinic for another reason. Systematic screening of C trachomatis infection should be implemented in STD units to enable the early treatment of patients and their recent sexual partners.Infecciones de transmisión sexual; Chlamydia trachomatis; Hábitos sexuales Análisis de la población con infección genital por Chlamydia trachomatis en una consulta de enfermedades de transmisión sexualResumen Introducción y objetivos: La infección genital por Chlamydia trachomatis (CT) tiene una alta incidencia en nuestro medio y su tratamiento precoz puede evitar complicaciones. Describimos la población de pacientes diagnosticados en una consulta de enfermedades de transmisión sexual. Material y métodos: Estudio observacional descriptivo de corte transversal de la población diagnosticada de infección por CT entre 2010 y 2011. Se recogieron datos demográficos, hábitos sexuales, asociación con otras infecciones de transmisión sexual (ITS) y diversos aspectos del tratamiento. Resultados: Encontramos positividad para CT en el 12,3% de las muestras. Se incluyeron 62 pacientes con una media de edad de 31 años. De estos 43 eran hombres y el 75% era heterosexual. El 87% de los pacientes había tenido una pareja sexual en los últimos 2 meses. El uso del preservativo se consideró deficiente en el 81, 79 y 65% de los pacientes en el sexo vaginal, oral y anal respectivamente. Aparecieron síntomas en el 13% y la ITS asociada con más frecuencia fueron las verrugas anogenitales. El tratamiento más usado fue la doxiciclina. Conclusiones: La detección de CT en nuestra consulta es elevada, procediendo en su mayoría las muestras de varones jóvenes. Demostramos una alta incidencia de inf...

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Incidence and risk factors associated with chlamydia in men who have sex with men: a cohort analysis of Victorian Primary Care Network for Sentinel Surveillance data

Abstract: These results show that MSM represent a key risk population for chlamydia in Australia and identify a number of high-risk MSM subpopulations for whom clinical and public health interventions are warranted.

Cited by 27 publications

References 26 publications

Incidence of and risk factors for type-specific anal human papillomavirus infection among HIV-positive MSM

Incidence of and risk factors for type-specific anal human papillomavirus infection among HIV-positive MSM

Frequency and determinants of consistent STI/HIV testing among men who have sex with men testing at STI outpatient clinics in the Netherlands: a longitudinal study

Analysis of Patients With Chlamydia trachomatis Genital Infection in an STD Clinic

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