Lymphogranuloma Venereum Proctitis in Men Who Have Sex With Men Is Associated With Anal Enema Use and High-Risk Behavior

Abstract

Apart from men with LGVP, men with gonorrheal proctitis or proctitis of unknown etiology exhibit high risk behavior. Enema use seems to play a key role in transmission of LGVP, and needs further investigation.

Lymphogranuloma venereum proctocolitis: a silent endemic disease in men who have sex with men in industrialised countries

“…The role of the CD4 cell count in modulating the clinical picture of LGV proctocolitis, as occurs with almost all opportunistic infections associated with HIV, is yet to be elucidated [37]. In a retrospective study no differences in the clinical picture of proctitis investigated by proctoscopy were noted among HIVpositive patients who did or did not receive HAART [38].…”

“…In some series there was a significant group with no or few symptoms, which could suggest that the number of cases reported might underestimate the real disease occurrence [37,38].…”

“…The majority reported high-risk sexual behaviour including unprotected anal intercourse, fisting, sharing sex toys, often connected to the sex party scene and involving international sexual networks [3]. In a cross-sectional study the use of enemas was found to be associated with a higher risk of LGV proctitis, probably because such a procedure leads to mucosal damage before receptive anal intercourse favouring the transmission of the disease [37].…”

“…The immune restoration inflammatory syndrome (IRIS) seen with many opportunistic infections after the initiation of HAART seems unlikely to modulate the clinical presentation of LGV proctocolitis, since most patients had been on anti-retroviral therapy (ART) for several years before the LGV diagnosis and no signs of IRIS were registered [37,38].…”

An Event-Level Comparison of Risk-Related Sexual Practices Between Black and Other-Race Men Who Have Sex with Men: Condoms, Semen, Lubricant, and Rectal Douching

“…18 Moreover, documentation of condom use often relies on aggregate retrospective self-reports, which have proven vulnerable to distortion, with MSM more commonly underestimating than overestimating unprotected PAI. 19 Additionally, Black MSM's participation in other behavioral practices known or suspected to influence vulnerability to HIV and other STIs, including lubricant use [20][21][22][23][24] and precoital rectal douching or enema use, [25][26][27][28][29][30] has received insufficient attention in the literature.…”