Sexual behaviour, STI knowledge and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) prevalence in an asymptomatic cohort in Ruhr‐area, Germany: PreYoungGo study

Abstract

Background and objectivesSTIs present a significant threat to individual and public health, disproportionately affecting youth. The study aimed to evaluate (a) the prevalence of asymptomatic Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among youth using a rapid assay platform, (b) the participants' sexual behaviour and STI knowledge, (c) the utility of the rapid assay in reducing diagnosis‐to‐treatment time.MethodsIn this study, 272 subjects (14–31 years) were included between 12/2016 and 7/2018. A questionnaire was used to collect sociodemographic data, sexual behaviour and STI knowledge. Prevalence of CT and NG infections were tested from oral, vaginal and anal swabs for women and oral, anal swabs and urine for men, using the Cepheid Xpert® CT/NG assay. Time intervals between (i) test to the time the patient were informed of the result (turn around time – TAT) and (ii) test to therapy initiation was documented.ResultsOf the 272 subjects (48.9% female, 48.9% male, undisclosed 2.2%), 56.6 % reported university education. 46.6% were men who have sex with men (MSM), and 47.4% of women and 63.1% of men had anal intercourse. 59.9% had previously been tested for HIV, while only 39.7% had for CT, 20.6% for NG. Among these asymptomatic youth 7.7% were positive for CT and 5.5% for NG. The localization of CT were 3.7% genital, 5.5% anal and 2.2% oral, while the corresponding localization of NG were 0.4%, 2.9%, 4.4% respectively. 91.8% of the participants were informed of a positive result within 24 h with a median TAT of 03:09 h. 73.3% initiated therapy within 24 h, with a median time from testing to therapy initiation being 06:50 h.ConclusionAsypmtomatic CT and NG infections are common and often not tested in persons at risk. The Cepheid Xpert® CT/NG assay is an effective strategy as it reduces STI diagnosis‐to‐treatment time to less than a day.

Testing as Prevention of Resistance in Bacteria Causing Sexually Transmitted Infections—A Population-Based Model for Germany

“…The study has a number of limitations. First of all, the prevalence values applied are just rough estimations based on cross-sectional assessments [ 27 , 28 , 29 ], because continuous surveillance of bacterial STIs is not performed in Germany. Second, the modelling ignores that screening and subsequent treatment as well as contemporaneous new infections will also affect the pre-existing prevalence.…”

“…Based on a recent meta-analysis, the prevalence of M. genitalium in any accessible cavity for screening (pharynx, anus, vagina) can be estimated to be around about 1% [ 29 ]. In a recent study on young German adolescents containing a high proportion of MSM among the male study population as well as individuals with high proportions of experience with “risk practices” like anal intercourse, 7.7% were positive for C. trachomatis and 5.5% for N. gonorrhoeae [ 28 ]. Considering the fact that a sexually highly active population was screened, for which number of sexual partners has been estimated to be about three times as high as for the general population for both sexes [ 46 ], and also considering the comparably high proportion of MSM among the screened males, it is likely that the true prevalence of N. gonorrhoeae and C. trachomatis among the general heterosexual population will be round about 1% or lower.…”

“…Asymptomatic infections with gonococci, C. trachomatis, or M. genitalium are not, however, infrequent events; on the contrary, subclinical infections occur quite often [ 26 ]. In Germany, this is particularly true for sexually highly active communities of men-having-sex-with-men (MSM) [ 27 ], but young, sexually active heterosexual populations are also considerably affected [ 28 , 29 ].…”

Sexualverhalten und Prävention sexuell übertragbarer Infektionen unter Berücksichtigung der SARS-CoV-2-Pandemie. Daten aus einem Versorgungszentrum für sexuelle Gesundheit und Medizin – WIR

“…Die Ergebnisse der Arbeit zeichnen ein inhomogenes Bild. Sie zeigen, dass unterschiedliche Zielgruppen und deren Sozialisierung in diversen Lebenswelten sowie sexuelle Präferenz, Partner*innenzahl, sexuelle Aktivität und Sexualpraktiken zu unterschiedlich hohen Risikokonstellationen für STI führen, was sich mit anderen Studien deckt [ 6 , 8 , 34 , 35 ]. So nutzen bspw.…”

“…Die mit 71 % hohe Nutzung des ORT von jungen, bis 39 Jahre alten, heterosexuellen Menschen zeigt den Bedarf und das Interesse Jugendlicher und junger Erwachsener an Wissen zu Sexualität und STI sowie an der Einschätzung ihres Sexualverhaltens und damit verbundener Gesundheitsrisiken. Der Bedarf an Wissen zu Sexualität und STI wird in der GeSiD-Studie detailliert beschrieben und auch in der PreYoungGo-Studie bestätigt [ 6 , 8 ]. Auch im GA sind 90 % der Klient*innen zwischen 20 und 39 Jahre alt, diese möchten beraten und häufig auch auf eine STI getestet werden.…”