Prevalence of Gastrointestinal Pathogens Detected by Multiplex Polymerase Chain Reaction in a Prospective Cohort of Men Who Have Sex With Men Taking Human Immunodeficiency Virus Preexposure Prophylaxis—New York City, 2019–2020

Sexual transmission of enteric pathogens among men who have sex with men (MSM) is well documented, although whether providers are cognizant of this risk when MSM patients present with gastrointestinal symptoms has not been studied. Over 34 months at a major tertiary metropolitan medical system, this study retrospectively analyzed 436 BioFire FilmArray Gastrointestinal results from 361 patients documented as MSM. An extensive chart review was performed, including specific sexual behaviors, socioeconomic risk factors, and whether providers charted a sexual history when a patient presented for care. Overall BioFire positivity rate was 62% with no significant difference in positivity between persons living with HIV and those without. Patients charted as sexually active had a significantly increased odds ratio (OR) of a positive result compared to those who were not. Anilingus had the highest OR. Providers charted any type of sexual history in 40.6% of cases, and HIV/infectious disease providers were significantly more likely to do this compared to other subspecialties. Sexual transmission of enteric pathogens within MSM is ongoing, and patients are at risk regardless of living with HIV. Not all sexual behaviors have the same associated risk, highlighting opportunities to decrease transmission. Increased provider vigilance and better patient education on sexual transmission of enteric pathogens are needed to reduce the disease burden. IMPORTANCE Our work adds several key findings to the growing body of literature describing the epidemiology of enteric pathogens as sexually transmitted infections among men who have sex with men (MSM). We analyzed clinical test results, housing status, provider awareness, sexual behaviors, and symptoms for 361 patients. We found that any sexual activity was associated with an increased risk of diarrheal pathogen detection, whereas being unhoused was not a risk factor. These findings suggest separate transmission networks between unhoused persons, who are also at risk of infectious diarrhea, and MSM. Moreover, our study suggested low awareness among patient-facing clinicians that diarrheal pathogens can be sexually transmitted. Together, our findings indicate an important opportunity to disrupt transmission cycles by educating clinicians on how to assess and counsel MSM patients.

show abstract

Giardia duodenalisin men who have sex with men: a systematic review

Dubey,

Sivachandran,

Wahab

et al. 2024

Frontline Gastroenterol

View full text Add to dashboard Cite

ObjectiveGiardia duodenaliscauses enteritis and malabsorption and can be sexually transmissible in men who have sex with men (MSM). The aim of this study was to explore factors associated with MSM withG. duodenalis.MethodsMEDLINE, Embase, Emcare, PubMed, Global Health and Web of Science were searched for manuscripts published up to February 2024. The primary author screened manuscript titles and abstracts; two authors independently reviewed full-text manuscripts for eligibility and risk of bias. We only included manuscripts that included MSM withG. duodenalisand explored at least one risk factor or association. Narrative data were synthesised following the population of a predetermined table.ResultsTwelve manuscripts were included in this review, including cross-sectional studies (n=7), case series (n=3), cohort study (n=1), case-control study (n=1), from the USA (n=8), the UK (n=1), Cuba (n=1), Spain (n=1) and Canada (n=1) published between 1977 and 2024 and included 191 MSM withG. duodenalis. This review highlighted demographic (living with HIV and living with HIV with a CD4 count <400 cells/mL), biological (coinfection withNeisseria gonorrhoeae,Chlamydia trachomatis,Escherichia coli,Entamoeba histolytica, non-pathogenic enteric parasites, intestinal spirochaetosis,Enterobius vermicularis, previousTreponema pallidum,N. gonorrhoeae,Shigellaspp, hepatitis A,E. histolyticaandG. duodenalis) and behavioural (lack of anal douching, oral-anal sex, oral sex, anal sex, group sex, use of sex toys, having more than one sexual partner per week, non-condom use, being part of a sexual network or having a sexual partner withG. duodenalis) factors associated with MSM withG. duodenalis.ConclusionThis review has highlighted some demographic, behavioural and biological factors associated with MSM withG. duodenalis, which provide insight for public health control strategies and future research.PROSPERO registration numberCRD42023477691.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Prevalence of Gastrointestinal Pathogens Detected by Multiplex Polymerase Chain Reaction in a Prospective Cohort of Men Who Have Sex With Men Taking Human Immunodeficiency Virus Preexposure Prophylaxis—New York City, 2019–2020

Cited by 4 publications

References 11 publications

Shigellosis in Taiwan: An old enteric pathogen with changing epidemiology and increasing antimicrobial resistance

Shigellosis in Taiwan: An old enteric pathogen with changing epidemiology and increasing antimicrobial resistance

Risk factors and provider awareness of sexually transmitted enteric pathogens among men who have sex with men

Giardia duodenalisin men who have sex with men: a systematic review

Contact Info

Product

Resources

About