1570. Genital Epithelial Disruption and Predisposition to Sexually Transmitted Infections in a Chicago Department of Public Health Clinic
Session: Poster Abstract Session: Clinical Infectious Diseases: Sexually Transmitted Infections
Saturday, October 10, 2015
Room: Poster Hall
  • IDweek poster_1570.pdf (364.1 kB)
  • Background: Sub-Saharan African studies link genital anaerobic bacteria to increased risk of genital coital injury (GCI), genital ulcers, and HIV. US trends of GCI are poorly described and have not been examined with STIs.  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 log-binomial models identified independent factors associated with GCI. Results are presented for scratches.

    Results:  As of May 2015, 269 patients have been enrolled: 102 women, 113 men who have sex with women (MSW), 54 men who have sex with men (MSM). Nearly half (47% of women and 52% of men) reported a past STI.  At the time of the survey, 15% of women were diagnosed with chlamydia (cervix/urine nucleic acid amplification test or NAAT), 3% with gonorrhea (cervix/urine NAAT) and 42.1% were diagnosed with bacterial vaginosis by wet prep.  Of men, 22.1% had chlamydia and 11% had gonorrhea identified by NAAT from pharynx, rectum, urine or urethra.  Over the past 6 months, 36% of women, 24% of MSW, and 22% of MSM reported ever having GCI scratches. Notably, sex ever being “rougher than you would have liked” in the past 6 months was reported by 53% of women, 37% of MSW, and 44% of MSM. Factors associated with GCI-scratchat p<0.05 for women were: rough sex [aPRR=2.04], sex during menses [aPRR=2.20], digital penetration [aPRR=2.14]. Similar factors for MSM and MSW were being uncircumcised [aPRR=1.84] and higher education [aPRR=0.44]. Rough sex was associated with GCI for MSW [aPRR=3.67] but was not significant for MSM [aPRR=1.88, p=0.13].

    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. The hypothesized relationship between anaerobic bacteria and genital epithelial disruption is supported by the increased risk of GCI for uncircumcised men.

    Marielle Fricchione, MD, Infectious Diseases, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, Supriya Mehta, MHS, PhD, Epidemiology, University of Illinois at Chicago School of Public Health, Chicago, IL and Tarek Mikati, MD, MPH, STI/HIV, Chicago Department of Public Health, Chicago, IL


    M. Fricchione, None

    S. Mehta, None

    T. Mikati, None

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