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The Etiology of Infectious Proctitis in Men Who Have Sex With Men Differs According to HIV Status

Bissessor, Melanie FAChSHM*†; Fairley, Christopher K. FRACP, PhD*†; Read, Timothy FAChSHM*†; Denham, Ian FRACP; Bradshaw, Catriona FAChSHM, PhD*†‡; Chen, Marcus FRCP, PhD*†

doi: 10.1097/OLQ.0000000000000022

We compared the spectrum of pathogens responsible for infectious proctitis between HIV-positive and HIV-negative men who have sex with men. Only 32% of men with herpes simplex virus (HSV)–associated proctitis had visible external anal ulceration.

The etiology of infectious proctitis among HIV-positive and HIV-negative men is as follows: chlamydia (23.4% vs. 21.7%, P = 0.7), gonorrhea (13.4% vs. 10.8%, P = 0.5), HSV-1 (14.2% vs. 6.5%, P = 0.04), HSV-2 (22% vs. 12.3%, P = 0.03), lymphogranuloma venereum (7.8% vs. 0.7%, P = 0.004), and multiple infections (17.7% vs. 8.6%, P = 0.017). Thirty-two percent with HSV proctitis had external anal ulceration.

From the *Melbourne School of Population Health, University of Melbourne, Melbourne, Australia; †Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Australia; and ‡Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia

The authors thank MSHC clinicians who contributed to the data, Jun Kit Sze and Afrizal for the data extraction from the electronic patient records, and the administrative staff at Melbourne Sexual Health Centre for retrieval of patient files. Melanie Bissessor was supported by an National Health and Medical Research Council postgraduate scholarship (ID 1038734).

Conflict of interest: None declared.

Correspondence: Melanie Bissessor, MD, FACHSM, 580 Swanston St, Carlton, Victoria 3053, Australia. E-mail:

Received for publication April 17, 2013, and accepted June 25, 2013.

© Copyright 2013 American Sexually Transmitted Diseases Association