Online Program

Genital Injury at a Chicago Department of Public Health Sexually Transmitted Infection Clinic

Sunday, November 1, 2015

Marielle Fricchione, MD, Pediatric Infectious Diseases, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
Tarek Mikati, MD, MPH, HIV/STI Services Division, Chicago Department of Public Health, Chicago, IL
Supriya Mehta, MHS, PhD, University of Illinois at Chicago School of Public Health, Chicago, IL
BACKGROUND: Sub-Saharan African studies link genital coital injury (GCI) to increased HIV risk. U.S. trends of GCI are poorly described.  We measured the prevalence of GCI and associated factors in patients attending an STI clinic in Chicago.

METHODS: This cross-sectional study used a standardized survey, and abstracted exam and lab data. The frequency of 5 types self-reported GCIs in the past 6 months were measured, dichotomized as ever vs. never for analysis: scratches, cuts or abrasions (scratches) to the penile or vaginal skin; genital soreness; bleeding of the genital skin; rectal bleeding; rectal soreness. Multivariable Poisson models with robust variance identified independent factors associated with GCI. Results are presented for scratches; models were similar for other outcomes.

RESULTS: By June 2015, 335 subjects were enrolled:122 women, 146 men who have sex with women (MSW), 67 men who have sex with men (MSM).  Over the past 6 months, 34% of women, 25% of MSW, and 22% of MSM reported ever having GCI scratches. Sex ever being “rougher than you would have liked” in the past 6 months was reported by 50% of women, 34% of MSW, and 45% of MSM. Factors associated with GCI-scratch at p<0.05 for women were: rough sex [aIRR=1.63] and sex during menses aIRR=1.30]. Similar factors for MSM and MSW were being uncircumcised [aIRR=1.64] and rough sex [aIRR=2.80].

CONCLUSION: The prevalence of self-reported GCI in this urban, U.S. STI clinic is similar to that of men and women in sub-Saharan Africa, suggesting a physiological rather than cultural mechanism.

Learning Areas:

Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Identify risk factors for genital injury at an urban U.S. sexually transmitted infection clinic.

Keyword(s): STDs/STI, Sexual Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a clinician specializing in infectious diseases with a particular interest in adolescents and sexually transmitted infections. My research with Supriya Mehta, MHS PhD, an epidemiologist at University of Illinois at Chicago with multiple publications on STI and HIV transmission in sub-Saharan Africa and Chicago, has focused on determining risk factors for genital injury with the goal to decrease the spread of HIV and STIs among adolescents and young adults.
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.