Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

2016 ◽  
Vol 28 (6) ◽  
pp. 573-583 ◽  
Author(s):  
Jamie Frankis ◽  
Lisa Goodall ◽  
Dan Clutterbuck ◽  
Abdul-Razak Abubakari ◽  
Paul Flowers
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Anal Intercourse ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Male Sex ◽  
Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

scholarly journals Sexually transmitted infection testing practices among ‘money boys’ and general men who have sex with men in Shanghai, China: objective versus self-reported status

Sexual Health ◽  
2014 ◽  
Vol 11 (1) ◽  
pp. 94 ◽  
Author(s):  
Lavinia Lin ◽  
Eric J. Nehl ◽  
Alvin Tran ◽  
Na He ◽  
Tony Zheng ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Odds Ratio ◽  
Monthly Income ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
High Prevalence ◽  
Testing Practices ◽  
Sex With Men ◽  
Money Boys

Little is known about sexually transmitted infection (STI) testing among Chinese men who have sex with men (MSM). This study describes the prevalence of STI testing, associated factors and the validity of STI self-reporting among Chinese MSM. Findings indicated a high prevalence of STIs and low testing rates among MSM in Shanghai. Monthly income was significantly associated with STI testing (odds ratio: 0.37, 95% confidence interval (CI): 0.18 to 0.76). Depression was significantly associated with STI testing for general MSM (odds ratio: 1.09, 95% CI: 1.01 to 1.17). Syphilis self-reported status had the highest validity (k = 0.33, χ2 = 3.76, 95% CI: –0.003 to 0.65). Efforts are needed to ensure that STI testing services are accessible to MSM in China. Future HIV and STI interventions should be tailored to the needs of different subsets of MSM.

scholarly journals Mosaic structure of the penA gene in the oropharynx of men who have sex with men negative for gonorrhoea

2020 ◽  
Vol 31 (3) ◽  
pp. 230-235 ◽  
Author(s):  
Antonella Marangoni ◽  
Giacomo Marziali ◽  
Melissa Salvo ◽  
Antonietta D’Antuono ◽  
Valeria Gaspari ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Dna Recombination ◽  
Genetic Material ◽  
Mosaic Structure ◽  
Multi Drug Resistance ◽  
Transmitted Infection ◽  
Neisseria Species ◽  
Sexually Transmitted ◽  
Pcr Products ◽  
Sex With Men

The oropharynx represents a crucial site for the emergence of multi-drug resistance in Neisseria gonorrhoeae. The mosaic penA alleles, associated with decreased susceptibility to cephalosporins, have emerged by DNA recombination with partial penA genes, particularly those from commensal pharyngeal Neisseria species. Here, we investigated the prevalence of the mosaic structure of the penA gene in the oropharynx of men who have sex with men testing negative for pharyngeal gonorrhoea. From January 2016 to June 2018, 351 gonorrhoea-negative men who have sex with men attending a sexually transmitted infection clinic in Italy were enrolled. Pharyngeal swabs underwent a real-time polymerase chain reaction (PCR) for the detection of the mosaic penA gene. In case of positivity, PCR products were sequenced and searched against several sequences of Neisseria strains. Overall, 31 patients (8.8%) were found positive for the presence of the mosaic penA gene. The positivity was significantly associated with previous cases of pharyngeal gonorrhoea (relative risk [RR]: 3.56, 95% confidence interval 1.44–8.80) and with recent exposure to beta-lactams (RR: 4.29, 95% confidence interval 2.20–8.38). All penA-positive samples showed a high relatedness (90–99%) with mosaic-positive Neisseria strains. Our data underline that commensal Neisseria species of the oropharynx may be a significant reservoir for genetic material conferring antimicrobial resistance in N. gonorrhoeae.

scholarly journals Voluntary medical male circumcision and HIV infection among men who have sex with men: Implications from a systematic review

2019 ◽  
Vol 7 ◽  
pp. 205031211986911 ◽  
Author(s):  
Chen Zhang ◽  
Han-Zhu Qian ◽  
Yu Liu ◽  
Sten H Vermund
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Male Circumcision ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Meta Analysis ◽  
Voluntary Medical Male Circumcision ◽  
Medical Male Circumcision ◽  
Sex With Men ◽  
Meta Analyses

Background: With the rapidly-increased HIV epidemic among men who have sex with men worldwide, the effectiveness of voluntary medical male circumcision as the tool of HIV prevention still remains undetermined. Purpose: In the current study, we conducted a systematic review and meta-analysis to assess the association between voluntary medical male circumcision and HIV risk among men who have sex with men. Methods and Conclusion: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, we conducted a comprehensive literature search through multiple databases. A total of 37 articles/abstracts were included in the analysis. We employed random-effects models and subgroup analyses based upon key study characteristics derived from empirical studies. A total of 117,293 men who have sex with men were included in the meta-analysis, and no randomized control trials have been identified. The odds of being HIV positive were 7% lower among men who have sex with men who were circumcised than among men who have sex with men who were uncircumcised (adjusted odds ratio, 0.93; 95% confidence interval, 0.88–0.99). The evidence for the potential protective effect of voluntary medical male circumcision was stronger among men who have sex with men in Asia and Africa (adjusted odds ratio, 0.62; 95% confidence interval, 0.53–0.73). Our meta-analyses may suggest a protective effect of voluntary medical male circumcision against HIV infection among men who have sex with men, especially in settings like Asia/Africa.

scholarly journals HIV testing practices and the potential role of HIV self-testing among men who have sex with men in Mexico

2016 ◽  
Vol 28 (3) ◽  
pp. 242-249 ◽  
Author(s):  
Catherine E Oldenburg ◽  
Katie B Biello ◽  
Amaya G Perez-Brumer ◽  
Joshua Rosenberger ◽  
David S Novak ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hiv Testing ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Intention To Use ◽  
Self Testing ◽  
Hiv Test ◽  
Self Test ◽  
Testing Practices ◽  
Sex With Men

The objective of this study was to characterize HIV testing practices among men who have sex with men in Mexico and intention to use HIV self-testing. In 2012, members of one of the largest social/sexual networking websites for men who have sex with men in Latin America completed an anonymous online survey. This analysis was restricted to HIV-uninfected men who have sex with men residing in Mexico. Multivariable logistic regression models were fit to assess factors associated with HIV testing and intention to use a HIV self-test. Of 4537 respondents, 70.9% reported ever having a HIV test, of whom 75.5% reported testing at least yearly. The majority (94.3%) indicated that they would use a HIV home self-test if it were available. Participants identifying as bisexual less often reported ever HIV testing compared to those identifying as gay/homosexual (adjusted odds ratio = 0.52, 95% confidence interval: 0.44–0.62). Having a physical exam in the past year was associated with increased ever HIV testing (adjusted odds ratio = 4.35, 95% confidence interval: 3.73–5.07), but associated with decreased interest in HIV self-testing (adjusted odds ratio = 0.66, 95% confidence interval: 0.48–0.89). The high intention to use HIV home self-testing supports the use of this method as an acceptable alternative to clinic- or hospital-based HIV testing.

scholarly journals Trends in antimicrobial susceptibility for azithromycin and ceftriaxone in Neisseria gonorrhoeae isolates in Amsterdam, the Netherlands, between 2012 and 2015

2017 ◽  
Vol 22 (1) ◽  
Author(s):  
Carolien M Wind ◽  
Maarten F Schim van der Loeff ◽  
Alje P van Dam ◽  
Henry JC de Vries ◽  
Jannie J van der Helm
Keyword(s):  
The Netherlands ◽  
Neisseria Gonorrhoeae ◽  
Treatment Strategies ◽  
Sex Partners ◽  
Hiv Status ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
New Treatment ◽  
Sex With Men ◽  
Infection Clinic

Resistance of Neisseria gonorrhoeae to azithromycin and ceftriaxone has been increasing in the past years. This is of concern since the combination of these antimicrobials is recommended as the first-line treatment option in most guidelines. To analyse trends in antimicrobial resistance, we retrospectively selected all consultations with a positive N. gonorrhoeae culture at the sexually transmitted infection clinic, Amsterdam, the Netherlands, from January 2012 through September 2015. Minimum inhibitory concentrations (MICs) for azithromycin and ceftriaxone were analysed per year, and determinants associated with decreased susceptibility to azithromycin (MIC > 0.25 mg/L) or ceftriaxone (MIC > 0.032 mg/L) were assessed. Between 2012 and 2015 azithromycin resistance (MIC > 0.5 mg/L) was around 1.2%, the percentage of isolates with intermediate MICs (> 0.25 and ≤ 0.5 mg/L) increased from 3.7% in 2012, to 8.6% in 2015. Determinants associated with decreased azithromycin susceptibility were, for men who have sex with men (MSM), infections diagnosed in the year 2014, two infected sites, and HIV status (HIV; associated with less decreased susceptibility); for heterosexuals this was having ≥ 10 sex partners (in previous six months). Although no ceftriaxone resistance (MIC > 0.125 mg/L) was observed during the study period, the proportion of isolates with decreased ceftriaxone susceptibility increased from 3.6% in 2012, to 8.4% in 2015. Determinants associated with decreased ceftriaxone susceptibility were, for MSM, infections diagnosed in 2014, and pharyngeal infections; and for heterosexuals, infections diagnosed in 2014 or 2015, being of female sex, and having ≥ 10 sex partners. Continued decrease of azithromycin and ceftriaxone susceptibility will threaten future treatment of gonorrhoea. Therefore, new treatment strategies are warranted.

scholarly journals Effect of Rectal Hygiene on Sexually Transmitted Infections Among HIV-Negative Men Who Have Sex with Men (MSM)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S103-S103
Author(s):  
Adiba Hassan ◽  
Jill Blumenthal ◽  
Michael Dube ◽  
Eric Ellorin ◽  
Katya Corado ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Text Messaging ◽  
Controlled Study ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Nutritional Habits ◽  
Sexually Transmitted ◽  
Rectal Douching ◽  
Sex With Men ◽  
Hiv Negative

Abstract Background Rectal gonorrhea (NG) and chlamydia (Connecticut) infections are common among men who have sex with men (MSM). Rectal douching/enema (RDE) is a common practice among MSM that can affect the rectal microbiome. It is unclear if this practice is associated with acquiring rectal infections (RI) with either NG or CT. Methods From 2013–2015, 398 adult HIV-negative MSM and transwomen were enrolled in a randomized controlled study on text messaging for adherence to pre-exposure prophylaxis (PrEP). Participants were surveyed on sexual behavior, frequency of RDE, drug use, and nutritional habits in conjunction with routine sexually transmitted infection testing. Pearson’s χ 2 and two sample t-tests were used to measure significance of RDE and other risk factors with RI. Multivariable logistic regression model was used to control for confounding and assess the association of RDE with RIs. Confounders (i.e., age, number anal receptive sex, number sex partners) were selected a priori for inclusion in the final model based on a causal model and statistical significance. Results Of 397 participants, 262 (67%) performed RDE and 132 (33%) had at least one NG or CT rectal infection over 48 weeks. Number of condomless anal receptive sex acts (mean = 19, P < 0.001), condom use for anal receptive sex (P = 0.017), number of male sex partners in past 3 months (mean = 14, P = 0.001), and the use of poppers (P < 0.001) were associated with RI. There was no significant association between nutritional habits, probiotic foods or supplements and RI, with the exception of energy bars (P = 0.029). Controlling for confounders, RI was associated with RDE less than weekly with OR = 1.02 (95% CI 0.52–1.99) while RDE weekly or more had OR = 2.08 (95% CI 1.03–4.17). Stratified by number of partners, MSMs with more than the median (>6) number of partners had OR = 4.96 (95% CI 1.29–19.03) if performing RDE less than weekly, and OR = 6.03 (95% CI 1.55–23.49) if weekly or more. Conclusion Rectal hygiene with douching/enemas is a common practice among MSMs on PrEP, which increases the odds of acquiring rectal NG and/or CT. This finding is suggestive for the use of rectal hygiene products/practices as potential targets for sexually transmitted infection prevention. Disclosures All authors: No reported disclosures.

Outcome of partner notification in patients diagnosed with genital warts attending a provincial clinic in East Anglia, England

2012 ◽  
Vol 23 (7) ◽  
pp. 518-519
Author(s):  
L Mercer ◽  
T C Harry
Keyword(s):  
Confidence Interval ◽  
Sexually Transmitted Infection ◽  
Odds Ratio ◽  
Partner Notification ◽  
Genital Warts ◽  
First Episode ◽  
Transmitted Infection ◽  
East Anglia ◽  
Sexually Transmitted ◽  
Relationship Duration

We retrospectively reviewed partner notification of patients diagnosed with first episode genital warts seen in the genitourinary (GU) medicine clinic, Great Yarmouth, UK, from January 2005 to December 2008. Of 947 patients diagnosed with genital warts, 486 (51.3%) were men, median age 25 years; 461 (48.7%) were women, median age 21 years and the partner notification index was 32.9%. In our cohort, 310 patients 33.2% reported having had a casual partner that could not be traced. The median relationship duration of partners whose contact attended was nine months and those whose contact did not attend was two months, (χ2 = 49.72, P < 0.0001). The odds ratio (OR) of a contact attending after seeing a health adviser was 2.94 (95% confidence interval [CI] = 1.79–4.86). In our cohort 35.6% of contacts whose partners saw a health adviser attended compared with 15.7% of contacts whose partner did not see a health adviser (χ2 = 19.7, P < 0.0001). Among the contacts 26% had genital warts, 28% had another sexually transmitted infection (STI) and 12% had both genital warts and another STI. The low partner notification index was associated with the reported casual partnerships seen in the cohort. Partner notification was enhanced when patients saw a health adviser.

scholarly journals Community-Directed Bacterial Sexually Transmitted Infection Testing Interventions Among Men Who Have Sex With Men: Protocol for an E-Delphi Study in Toronto, Canada (Preprint)

2019 ◽  
Author(s):  
Ann N Burchell ◽  
Ryan Lisk ◽  
Anna Yeung ◽  
Jayoti Rana ◽  
Jean Bacon ◽  
...  
Keyword(s):  
Literature Review ◽  
Delphi Study ◽  
Barriers And Facilitators ◽  
Delphi Panel ◽  
Community Members ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
A Priority ◽  
Sex With Men

BACKGROUND HIV-positive and HIV-negative (gay, bisexual, and other) men who have sex with men (MSM) have experienced a dramatic increase in bacterial sexually transmitted infections (STIs)—syphilis, gonorrhea, and chlamydia. STI testing and treatment mitigate adverse health outcomes and substantially reduce transmission; yet, testing rates remain below recommended levels. Innovation is needed to produce the required increases in testing levels, frequency, and the use of appropriate testing technologies in ways that are engaging, nonstigmatizing, and acceptable to men. OBJECTIVE The aim of this study is to build consensus with regard to interventions with the greatest potential for improving local STI testing services for MSM communities in Toronto, Canada. METHODS Following a literature review of evidence regarding the effectiveness of novel testing interventions, and focus groups, and surveys to describe local barriers and facilitators of testing among MSM, we will conduct a Web-based, modified Delphi study (e-Delphi). We will form expert panels of community members and STI test providers. Panelists will rate potential interventions in terms of their priority, using a 7-point Likert scale from definitely not a priority to definitely a priority. They will also rank their preferences by selecting their top 3 preferred interventions. Surveys will be distributed in 3 rounds, with feedback on the distribution of responses from preceding rounds provided in rounds 2 and 3. We will define consensus as having ≥60% (18/30) members indicate a preference within 2 adjacent response points. Qualitative data on disagreements will be obtained using open-ended text responses to explain for ratings and rankings that are different from the majority. RESULTS On the basis of a literature review and identification of barriers and facilitators to STI testing among community members and test providers in Toronto, we have selected 8 potential interventions for inclusion in the e-Delphi panel surveys. These include 4 interventions that streamline STI testing for asymptomatic individuals, 2 interventions that are targeted at clients and 2 interventions that are targeted at providers. CONCLUSIONS Findings will provide community direction for informed decision making regarding the implementation of STI testing interventions in this setting. They will characterize the intervention climate for innovation to STI testing services, including perceived needs for changes to test delivery, relative priorities for change, and readiness for implementation. These methods may be transferable to other urban jurisdictions experiencing similar epidemics and for other contexts where stakeholder input is needed to manage sensitive areas of concern. INTERNATIONAL REGISTERED REPOR PRR1-10.2196/13801

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