The Centers for Disease Prevention and Control (CDC) recommends gonorrhea (GC) and chlamydia (CT) screening for men who have sex with men (MSM) at all anatomical sites (pharyngeal, urethral, rectal) at which they report exposure. We conducted this study to assess the value of patient-reported exposure with respect to observed GC/CT rectal and urethral infection rates in a cohort of YBMSM screened at an urban STD clinic in Jackson, Mississippi.
507 BMSM aged 15-29 years reporting a history of anal sex in the past 90 days completed a computer-assisted self-interview at a sexual health clinic and were screened for rectal and urethral GC/CT regardless of reported exposure. GC/CT infection rates were calculated per anatomic site by 90 day reported exposure with and without condom use.
The mean participant age was 22.6 years (SD = 3.2) The overall GC/CT infection rate was 26.9%. Among YBMSM that denied RAS, rectal GC/CT infection rates were 19.4%. Among those who reported at least one episode of RAS, the infection rate was 30.6%. Just over one-third of the sample (35.3%) reported condomless receptive anal sex (RAS), at least once, in the past 90 days, and over one-quarter (27.0%) reported condomless insertive anal sex (IAS). Reported condom use for RAS did not significantly reduce rectal GC/CT infection rate (p = 0.10). Among YBMSM that reported no IAS, urethral GC/CT infection rates were 6.7%. (p = 0.10). Reported condom use for IAS significantly reduced GC/CT urethral infections (p= 0.08).
GC/CT infection rates in this population were high. A large number of infections were identified at anatomical sites not consistent with reported exposure in the past 90 days. Clinicians caring for YBMSM should consider screening individuals for GC/CT at all anatomical sites regardless of reported exposure at least at the moment of initial care. Report of consistent condom use protected patients reporting IAS from urethral infections.
L. Beauchamps, None
R. Crosby, None
P. A. Chan, None
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