Sexually Transmitted Diseases

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Risk Factors for Rectal Gonococcal Infection Amidst Resurgence in HIV Transmission

KIM, ANDREA A. MPH*†; KENT, CHARLOTTE K. MPH*; KLAUSNER, JEFFREY D. MD, MPH*

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Abstract

Background: Rectal gonorrhea in men has been increasing in San Francisco since 1995.

Goal: The goal was to determine behavioral risk factors associated with rectal gonorrhea (RGC) among men who have sex with men (MSM) by HIV serostatus.

Study Design: All men reporting receptive anal sex in the last 6 months are screened for RGC, regardless of reported condom use, at San Francisco's municipal sexually transmitted disease (STD) clinic. We surveyed a convenience sample of men screened for RGC at the clinic.

Results: Among 564 MSM surveyed, 7.1% had RGC. HIV-positive MSM were significantly more likely (relative risk, 3.5, 95% confidence interval, 1.9–5.8) to have RGC. Behavioral risks for RGC infection varied significantly by HIV serostatus. HIV-positive MSM engaging in anonymous sex were at highest risk for RGC infection. Drug use during anal sex was the strongest risk factor for RGC infection among HIV-negative or unknown HIV status MSM.

Conclusion: Our data suggest that STD and HIV prevention efforts among MSM in San Francisco must consider the role that HIV serostatus plays in acquisition of new infections.

© Copyright 2003 American Sexually Transmitted Diseases Association

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