HIV, Rectal Chlamydia, and Rectal Gonorrhea in Men Who Have Sex With Men Attending a Sexually Transmitted Disease Clinic in a Midwestern US City

Turner, Abigail Norris PhD*; Reese, Patricia Carr MPH*; Ervin, Melissa MT (ASCP); Davis, John A. MD, PhD*; Fields, Karen S. RN; Bazan, Jose A. DO*†

Sexually Transmitted Diseases: June 2013 - Volume 40 - Issue 6 - p 433–438
doi: 10.1097/OLQ.0b013e31828fd163
Original Study

Background: Men who have sex with men (MSM) who report receptive anal intercourse (RAI) are currently recommended to undergo at least annual screening for rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infection.

Methods: Using standard culture methods, we assessed the prevalence of rectal GC/CT among MSM who reported RAI in the last year (n = 326) at an urban sexually transmitted disease (STD) clinic in a midwestern US city. A subset (n = 125) also underwent rectal GC/CT screening via nucleic acid amplification testing. We examined the associations between HIV status and prevalence of rectal GC and rectal CT using unadjusted and adjusted logistic regression models.

Results: The prevalence of rectal GC, rectal CT, and either rectal infection was 9%, 9%, and 15% by culture and 24%, 23%, and 38% by nucleic acid amplification testing, respectively. HIV was not associated with rectal GC prevalence in unadjusted or adjusted analyses. HIV-positive status was significantly associated with increased rectal CT prevalence in unadjusted models (odds ratio, 2.18; 95% confidence interval, 1.04–4.60); this association increased after multivariable adjustment (odds ratio, 3.14; 95% confidence interval, 1.37–7.19).

Conclusions: Men who have sex with men reporting RAI had a high prevalence of rectal GC and rectal CT. HIV-positive status was significantly associated with prevalent rectal CT but not with prevalent rectal GC.

In a sexually transmitted disease clinic study of men who have sex with men, 15% of men were tested positive for rectal gonorrhea or rectal chlamydia via culture and 38% had rectal gonorrhea or rectal chlamydia via nucleic acid amplification testing.

From the *Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Ohio State University, OH; and †Sexual Health Clinic, Columbus Public Health, Columbus, OH

This project was supported by the Ohio State University Center for Clinical and Translational Science (OSU CCTS). The OSU CCTS is supported by the National Center for Research Resources, Grant UL1RR025755, and is now at the National Center for Advancing Translational Sciences, Grant 8UL1TR000090-05. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Advancing Translational Sciences or the National Institutes of Health. The authors thank Dr Mysheika Williams Roberts for her support of this project.

Conflicts of interest: None declared.

Correspondence: Abigail Norris Turner, PhD, Division of Infectious Diseases, Ohio State University, Doan N-1145, 410 W 10th Ave, Columbus, OH 43210. E-mail: ant@osumc.edu.

Received for publication November 15, 2012, and accepted February 20, 2013.

© Copyright 2013 American Sexually Transmitted Diseases Association