Sexual transmission of enteric pathogens in men who have sex with men (MSM) has been described since the 1970s. Recently, an increasing number of enteric infection outbreaks have been reported in MSM. This article summarizes recent outbreaks and discusses the key issues for prevention and control.
Sexually transmissible enteric infections (STEIs) can spread rapidly and internationally within highly connected MSM populations and are often associated with antimicrobial resistance (AMR). The infections often cluster in high-risk groups of HIV-positive MSM who are more likely to engage in diverse sexual practices and chemsex, and to have multiple other sexually transmitted infections (STIs).
The roles of asymptomatic and/or persistent infection and other contextual factors in STEI transmission are not well described. STEI-associated AMR is increasing and has potential to spread rapidly in MSM, warranting further public health attention. A better understanding of the factors associated with sexual transmission will enable the development of more effective control measures. A holistic approach that promotes health and wellbeing as well as infection prevention and management is needed.
aCentre for Molecular Epidemiology and Translational Research, Institute for Global Health, University College London
bThe National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections, University College London
cHIV & STI Department, National Infection Service, Public Health England, London, UK
Correspondence to Holly Mitchell, Centre for Molecular Epidemiology and Translational Research, Institute for Global Health, University College London, 3rd Floor Mortimer Market Centre, Off Capper Street, WC1E 6JB London, UK. Tel: +44 20 3108 2067; e-mail: firstname.lastname@example.org