- Sexually active men who have sex with men (MSM) are not routinely screened for rectal sexually transmitted infections (rSTIs).
- Annual screening rate was 1 in 4 for HIV-negative MSM without preexposure prophylaxis (PrEP) use.
Why this matters
- Increased STI screening, especially for rSTIs in MSM, is paramount to reducing overall burden.
- Use screening to encourage PrEP uptake in HIV-negative patients, engage/reengage HIV-infected men in care to achieve/maintain viral suppression.
- 403 MSM; 68.7% (277) reported screening for any STI, 40.2% (162) for rSTIs in the past 12 months.
- rSTI screening rate by category:
- HIV-negative, no PrEP (n=233): 25.7%.
- HIV-negative, PrEP use (n=88): 69.3%.
- HIV+ (n=69): 59.4%.
- Status was unknown in 13 patients.
- 20.3% (82) reported bacterial STI, 54.1% (218) reported condomless anal sex with casual partners, 52.4% (211) reported any receptive anal sex in past 3 months.
- Multivariate rSTI screening predictors:
- HIV-negative, no PrEP: provider-offered testing (adjusted prevalence ratio [aPR], 2.21, P=.001), condomless anal sex with casual partners (aPR, 1.63; P=.046).
- HIV negative, PrEP: syphilis diagnosis (aPR, 1.33; P=.002).
- HIV-positive: provider-initiated sex discussions (aPR, 1.46; P=.022).
- Venue-based, time-space survey determining rSTI screening prevalence, factors predicting screening among MSM, June-December 2017.
- Funding: CDC.
- Self-report bias.
- Receptive anal sex analyzed outside main time frame.