Rectal and urethral STIs among young MSM: Prevalence, demographic and behavioral risk factors, and implications for HIV risk
Method: HIV negative YMSM (18-29 years) were recruited online and through community-based HIV testing centers in three cities (Atlanta, Chicago, New York). As part of their baseline assessment for an HIV prevention trial, participants completed self-report measures and self-collected urine and rectal swabs for Chlamydia/gonorrhea testing. To date we have enrolled 596 YMSM (target N = 750).
Results: Rectal STIs were more prevalent (12.9%) than urethral (3.9%). The sample was highly diverse, but there were no significant differences in STI rates. Younger YMSM had significantly higher rectal STI rates than older YMSM: 15.5% vs. 10.1% (p < .05). Sexual positioning during condomless anal sex (CAS) in prior 3 months was strongly associated with rectal STIs (p < .01): no CAS 11.1%, insertive CAS only 7.6%, insertive and receptive CAS 11.5%, and receptive only CAS 22.1%. No association was found between use of lubricants and rectal STIs.
Discussion: Self-collection of rectal swabs with mail return for testing is feasible. Rectal Chlamydia/gonorrhea was more than 3 times more common than urethral infections, highlighting the public health significance of screening among YMSM and viability as a proxy biomedical endpoint for HIV prevention trials.
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences
Describe the prevalence of rectal and urethral gonorrhea and chlamydia in a large sample of young MSM. Discuss demographic and behavioral factors associated with rectal and urethral gonorrhea and chlamydia diagnosis among young MSM
Keyword(s): HIV Risk Behavior, STDs/STI
Qualified on the content I am responsible for because: I have my PhD years of experience conducting research in the realm of HIV. I have been the PI of 8 NIH grants related to HIV/AIDS epidemiology and prevention. Among my scientific interests are HIV/STI prevention among young men who have sex with men.
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.