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Characteristics Associated With Urethral and Rectal Gonorrhea and Chlamydia Diagnoses in a US National Sample of Gay and Bisexual Men: Results From the One Thousand Strong Panel

Grov, Christian PhD, MPH; Cain, Demetria MPH; Rendina, H. Jonathan PhD, MPH; Ventuneac, Ana PhD; Parsons, Jeffrey T. PhD

Sexually Transmitted Diseases: March 2016 - Volume 43 - Issue 3 - p 165–171
doi: 10.1097/OLQ.0000000000000410
Original Study

Background Gay and bisexual men are at elevated risk for Neisseria gonorrhoeae and Chlamydia trachomatis (GC/CT). Rectal GC/CT symptoms may be less obvious than urethral, increasing opportunities for undiagnosed rectal GC/CT.

Methods A US national sample of 1071 gay and bisexual men completed urethral and rectal GC/CT testing and an online survey.

Results In total, 6.2% were GC/CT positive (5.3% rectal, 1.7% urethral). We calculated adjusted (for education, race, age, relationship status, having health insurance, and income) odds ratios for factors associated with rectal and urethral GC/CT diagnoses. Age was inversely associated with urethral and rectal GC/CT. Compared with white men, Latinos had significantly greater odds of rectal GC/CT. Among men who reported anal sex, those reporting only insertive sex had lower odds of rectal GC/CT than did men who reported both insertive and receptive. There was a positive association between rectal GC/CT and number of male partners (<12 months), the number of anal receptive acts, receptive condomless anal sex (CAS) acts, and insertive CAS acts. Compared with those who had engaged in both insertive and receptive anal sex, those who engaged in only receptive anal sex had lower odds of urethral GC/CT. The number of male partners (<12 months) was associated with increased odds of urethral GC/CT.

Conclusions Rectal GC/CT was more common than urethral and associated with some demographic and behavioral characteristics. Our finding that insertive CAS acts was associated with rectal GC/CT highlights that providers should screen patients for GC/CT via a full range of transmission routes, lest GC/CT go undiagnosed.

A US national sample of gay and bisexual men completed at-home self-administered testing for urethral and rectal gonorrhea/chlamydia. In total, 6.2% were gonorrhea/chlamydia positive (5.3% rectal, 1.7% urethral).

From the Center for HIV/AIDS Educational Studies and Training, New York, NY

Acknowledgments: The authors would like to acknowledge other members of the One Thousand Strong Study Team (Dr Tyrel Starks, Michael Castro, Ruben Jimenez, Dr Jonathan Lassiter, Brett Millar, Chloe Mirzayi, Raymond Moody, and Anita Viswanath) and other staff from the Center for HIV/AIDS Educational Studies and Training (Qurrat-Ul Ain, Andrew Cortopassi, Chris Hietikko, Doug Keeler, Chris Murphy, Carlos Ponton, and Brian Salfas). The authors would also like to thank the staff at Community Marketing Inc (David Paisley, Thomas Roth, and Heather Torch) and Dr Patrick Sullivan, Jessica Ingersoll, Deborah Abdul-Ali, and Doris Igwe at the Emory Center for AIDS Research (P30 AI050409). Finally, special thanks to Dr Jeffrey Schulden at the National Institutes on Drug Abuse (NIDA).

Conflict of Interest: None.

Sources of Funding: The One Thousand Strong study was funded by the National Institutes of Health (NIH)/NIDA (R01 DA 036466: Jeffrey T. Parsons and Christian Grov). H. Jonathon Rendina was funded by a Career Development Award from the NIH/NIDA (K01-DA039030).

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Correspondence: Christian Grov, PhD, MPH, Department of Health and Nutrition Sciences, Brooklyn College of CUNY, 2900 Bedford Ave, Brooklyn, NY 11210. E-mail:

Received for publication October 7, 2015, and accepted November 24, 2015.

© Copyright 2016 American Sexually Transmitted Diseases Association