BMJ Open. 2013 May 28;3(5). doi: 10.1136/bmjopen-2013-002775.
Prevalence and factors associated with asymptomatic gonococcal and chlamydial infection among US Navy and Marine Corps men infected with the HIV: a cohort study.
BMJ open
Robert J Carpenter, Oliver N Refugio, Nehkonti Adams, Kevin P O'Brien, Mark D Johnson, Harold L Groff, Ryan C Maves, Mary F Bavaro, Nancy F Crum-Cianflone
Affiliations
Affiliations
- Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, California, USA.
PMID: 23793671
PMCID: PMC3657657 DOI: 10.1136/bmjopen-2013-002775
Abstract
OBJECTIVES: Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) can facilitate transmission of HIV. Men who have sex with men (MSM) may harbour infections at genital and extragenital sites. Data regarding extragenital GC and CT infections in military populations are lacking. We examined the prevalence and factors associated with asymptomatic GC and CT infection among this category of HIV-infected military personnel.
DESIGN: Cross-sectional cohort study (pilot).
SETTING: Infectious diseases clinic at a single military treatment facility in San Diego, CA.
PARTICIPANTS: Ninety-nine HIV-positive men were evaluated-79% men who had sex with men, mean age 31 years, 36% black and 33% married.
INCLUSION CRITERIA: male, HIV-infected, Department of Defense beneficiary.
EXCLUSION CRITERIA: any symptom related to the urethra, pharynx or rectum.
PRIMARY OUTCOME MEASURES: GC and CT screening results.
RESULTS: Twenty-four per cent were infected with either GC or CT. Rectal swabs were positive in 18% for CT and 3% for GC; pharynx swabs were positive in 8% for GC and 2% for CT. Only one infection was detected in the urine (GC). Anal sex (p=0.04), male partner (OR 7.02, p=0.04) and sex at least once weekly (OR 3.28, p=0.04) were associated with infection. Associated demographics included age <35 years (OR 6.27, p=0.02), non-Caucasian ethnicity (p=0.03), <3 years since HIV diagnosis (OR 2.75, p=0.04) and previous sexually transmitted infection (STI) (OR 5.10, p=0.001).
CONCLUSIONS: We found a high prevalence of extragenital GC/CT infection among HIV-infected military men. Only one infection was detected in the urine, signalling the need for aggressive three-site screening of MSM. Clinicians should be aware of the high prevalence in order to enhance health through comprehensive STI screening practices.
Keywords: DADT; MSM; chlamydia; gonorrhea
References
- Sex Transm Dis. 2002 Apr;29(4):189-95 - PubMed
- Sex Transm Dis. 2008 Jul;35(7):637-42 - PubMed
- J Sex Res. 2011 Mar;48(2-3):218-53 - PubMed
- AIDS. 1999 Feb 4;13(2):155-66 - PubMed
- AIDS Behav. 2011 Apr;15 Suppl 1:S9-17 - PubMed
- MMWR Recomm Rep. 2010 Dec 17;59(RR-12):1-110 - PubMed
- AIDS Patient Care STDS. 2005 Aug;19(8):495-8 - PubMed
- J Infect Dis. 2001 Nov 1;184(9):1216-9 - PubMed
- Sex Transm Dis. 2004 Jul;31(7):443-7 - PubMed
- AIDS Patient Care STDS. 2008 Dec;22(12):947-54 - PubMed
- Sex Transm Dis. 2003 Jul;30(7):562-7 - PubMed
- Clin Infect Dis. 2005 Jul 1;41(1):67-74 - PubMed
- Sex Transm Infect. 2012 Jun;88(4):266-71 - PubMed
- Sex Transm Dis. 2012 Jun;39(6):482-4 - PubMed
- Clin Infect Dis. 2000 Apr;30(4):742-8 - PubMed
- Mil Med. 2002 Jun;167(6):496-500 - PubMed
- Mil Med. 2005 Dec;170(12):1019-25 - PubMed
- Nat Rev Microbiol. 2004 Jan;2(1):33-42 - PubMed
- N Engl J Med. 2010 Dec 16;363(25):2380-1 - PubMed
- Mil Med. 2011 Jun;176(6):705-10 - PubMed
- AIDS Behav. 2012 Jan;16(1):121-31 - PubMed
- Infect Dis Clin North Am. 2005 Jun;19(2):281-96 - PubMed
- Mil Med. 2007 Jul;172(7):770-2 - PubMed
- J Infect Dis. 1998 Oct;178(4):1202-4 - PubMed
- Lancet. 1997 Jun 28;349(9069):1868-73 - PubMed
- Sex Transm Infect. 2002 Feb;78(1):40-4 - PubMed
- Sex Transm Dis. 2010 Dec;37(12):771-6 - PubMed
- J Homosex. 2008;54(3):277-9 - PubMed
- Sex Transm Dis. 2008 Dec;35(12 Suppl):S4-12 - PubMed
- Sex Transm Dis. 2009 Aug;36(8):507-11 - PubMed
Publication Types