267804 Screening for Neisseria gonorrhoeae and Chlamydia trachomatis among HIV-positive MSM age 50 and over

Monday, October 29, 2012

Perry Halkitis, PhD, MPH , Steinhardt School of Culture, Education and Human Development, New York University, New York, NY
Rafael E. Perez Figueroa, MD, MPH , Center for Health, Identity Behavior and Prevention Studies; Steinhardt school of culture, education, and human development, New York University, New York City, NY
Molly Kingdon, MA , Center for Health, Identity, Behaviors, and Prevention Studies; Steinhardt School of Culture, Education, and Human Development, New York University, New York City, NY
Sandra Kuprat, MS, MA , Center for Health, Identity, Behaviors, and Prevention Studies;Steinhardt school of culture, education, and human development, New York University, New York City, NY
Demetre Daskalakis, MD , Department of Medicine, NYU Langone Medical Center, New York City, NY
  
ABSTRACT

Background: The Centers for Disease Control and Prevention recommend annual screening for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) in all sexually active MSM. However, uptake of screening strategies in clinical practice remains poor. This study aimed to evaluate the rate at which asymptomatic HIV-positive MSM ages 50 and older test positive for pharyngeal, rectal, and urethral GC/CT infections, and to characterize the STI-positive participants.

Methods: This cross-sectional pilot study screened 99 HIV-positive MSM age 50 and over for asymptomatic sexually transmitted infections (STI). STI testing included GC cultures from oropharyngeal and rectal swabs, nucleic acid amplification testing (NAAT) for GC and CT from urine, and NAAT for CT from a rectal swab. A computer-administered survey and a calendar-based assessment were used to assess known predictors for HIV transmission.

Results: Four percent of the participants tested positive for an STI. Two percent tested positive for urine CT and an additional 2% for rectal CT. The STI-infected men engaged in equal proportion (50%) in unprotected anal intercourse with seroconcordant partners and unprotected anal intercourse with serodiscordant partners. Three men reported using marijuana and other illicit drugs (i.e. powder cocaine, crack cocaine, ecstasy).

Conclusions: Extra-genital sites are substantial reservoirs of undetected GC and CT infections. Efforts should be directed to increase the uptake of STI screening guidelines in clinical practice. Furthermore, our findings support the importance of exploring the impact and interplay of HIV, sexual risk-taking, and substance use among aging MSM.

Learning Areas:
Clinical medicine applied in public health
Other professions or practice related to public health
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related research

Learning Objectives:
Discuss the implementation of current sexually transmitted infections screening guidelines among HIV-positive MSM age 50 and over

Keywords: STD, Sexual Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Research Assistant at the Center for Health, Identity, Behaviors, and Prevention Studies. Among my scientific interests has been the study of health disparities among sexual and racial/ethnic minorities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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