Takeaway
- Cumulative rectal gonorrhoea infection history increases subsequent HIV infection risk in men who have sex with men (MSM), independent of other sexually transmitted infections (STIs), sexual behaviours.
Why this matters
- Use STIs in MSM patients as prompt for HIV preexposure prophylaxis (PrEP).
- Ensure counselling among MSM with history of STIs, especially repeated rectal gonorrhoea, reporting poor adherence or stopped PrEP.
Key results
- 22,815 test events in 8941 MSM included.
- 2.5% (227) received HIV diagnoses.
- 3.7% (849) positive rectal gonorrhoea infections in 718 MSM; 6.9% (613), 1.2% (105) were diagnosed 1 time, >1 time, respectively.
- Among MSM with repeat infections, majority had 2 rectal chlamydia (81%), rectal gonorrhoea (83%), syphilis (90%).
- HIV risk higher for ≥2 prior rectal gonorrhoea diagnoses (aHR, 6.27; P<.001), 1 prior (aHR, 2.09; P=.016) vs MSM with no rectal gonorrhoea.
- Inconsistent condom use (aHR, 1.83; P<.001), ≥6 partners in last 6 months (aHR, 1.57; P=.007) increased HIV risk.
Study design
- Retrospective sentinel surveillance high caseload HIV data analysis of relationship between cumulative STIs, having an STI at prior test event, and risk of subsequent infection among Australian MSM during 2007-2014.
- Funding: Victorian Department of Health and Human Services.
Limitations
- Unmeasured confounders.
- Limited generalisability.
- Methodology.
References
References
