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Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru.
Sex Transm Dis. 2018 09; 45(9):607-614.ST

Abstract

BACKGROUND

Gonorrhea (Neisseria gonorrhoeae [GC]) and chlamydia (Chlamydia trachomatis [CT]) disproportionately affect men who have sex with men (MSM), and public health implications vary by anatomic site and bacterial agent. Urethral and rectal GC and CT can increase risk of HIV transmission, whereas pharyngeal GC may be a reservoir for antimicrobial resistance. To define screening priorities in Latin America, we compare differences in the prevalence and correlates of urethral, pharyngeal, and rectal GC and CT among MSM in Peru.

METHODS

A cross-sectional sample of 787 MSM from Lima was screened between 2012 and 2014. We described prevalence of urethral, pharyngeal, and rectal GC and CT infection and conducted bivariate analyses of associations with social, behavioral, and biological characteristics. Poisson regression analyses assessed the correlates of each infection at each anatomic site.

RESULTS

The most commonly symptomatic infection (urethral GC; 42.1%) was the least prevalent (2.4%). The most prevalent infections were rectal CT (15.8%) and pharyngeal GC (9.9%). Rectal CT was the least commonly symptomatic (2.4%) infection, and was associated with younger age (adjusted prevalence ratio [95% confidence interval], 0.96 [0.94-0.98]), HIV infection (1.46 [1.06-2.02]), and pasivo (receptive; 3.59 [1.62-7.95]) and moderno (versatile; 2.63 [1.23-5.60]) sexual roles.

CONCLUSIONS

Results highlight limitations of current syndromic screening strategies for sexually transmitted diseases in Peru, wherein urethral CT and rectal GC and CT may be missed due to their frequently asymptomatic presentations. Successful management of GC and CT infections among MSM in low-resource settings requires differentiating between bacterial agent, symptomatic presentation, associated risk factors, and public health implications of untreated infection at different anatomic sites.

Authors+Show Affiliations

College of Medicine, University of Tennessee Health Science Center, Memphis, TN. South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA. Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.Columbia University Mailman School of Public Health, New York, NY.South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.US Naval Medical Research Unit-6, Callao, Peru.South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA. Department of Internal Medicine, Division of Infectious Diseases, McGovern Medical School at UTHealth, Houston, TX.Asociación Civil Impacta Salud y Educación Centro de Investigaciones Tecnológicas Biomédicas y Medioambientales, Lima, Peru. Department of Global Health, University of Washington, Seattle, WA.Asociación Civil Impacta Salud y Educación Department of Global Health, University of Washington, Seattle, WA.South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30102262

Citation

Passaro, Ryan Colby, et al. "Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru." Sexually Transmitted Diseases, vol. 45, no. 9, 2018, pp. 607-614.
Passaro RC, Segura ER, Perez-Brumer A, et al. Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru. Sex Transm Dis. 2018;45(9):607-614.
Passaro, R. C., Segura, E. R., Perez-Brumer, A., Cabeza, J., Montano, S. M., Lake, J. E., Sanchez, J., Lama, J. R., & Clark, J. L. (2018). Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru. Sexually Transmitted Diseases, 45(9), 607-614. https://doi.org/10.1097/OLQ.0000000000000816
Passaro RC, et al. Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru. Sex Transm Dis. 2018;45(9):607-614. PubMed PMID: 30102262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru. AU - Passaro,Ryan Colby, AU - Segura,Eddy R, AU - Perez-Brumer,Amaya, AU - Cabeza,Jeanne, AU - Montano,Silvia M, AU - Lake,Jordan E, AU - Sanchez,Jorge, AU - Lama,Javier R, AU - Clark,Jesse L, PY - 2018/8/14/entrez PY - 2018/8/14/pubmed PY - 2019/10/1/medline SP - 607 EP - 614 JF - Sexually transmitted diseases JO - Sex Transm Dis VL - 45 IS - 9 N2 - BACKGROUND: Gonorrhea (Neisseria gonorrhoeae [GC]) and chlamydia (Chlamydia trachomatis [CT]) disproportionately affect men who have sex with men (MSM), and public health implications vary by anatomic site and bacterial agent. Urethral and rectal GC and CT can increase risk of HIV transmission, whereas pharyngeal GC may be a reservoir for antimicrobial resistance. To define screening priorities in Latin America, we compare differences in the prevalence and correlates of urethral, pharyngeal, and rectal GC and CT among MSM in Peru. METHODS: A cross-sectional sample of 787 MSM from Lima was screened between 2012 and 2014. We described prevalence of urethral, pharyngeal, and rectal GC and CT infection and conducted bivariate analyses of associations with social, behavioral, and biological characteristics. Poisson regression analyses assessed the correlates of each infection at each anatomic site. RESULTS: The most commonly symptomatic infection (urethral GC; 42.1%) was the least prevalent (2.4%). The most prevalent infections were rectal CT (15.8%) and pharyngeal GC (9.9%). Rectal CT was the least commonly symptomatic (2.4%) infection, and was associated with younger age (adjusted prevalence ratio [95% confidence interval], 0.96 [0.94-0.98]), HIV infection (1.46 [1.06-2.02]), and pasivo (receptive; 3.59 [1.62-7.95]) and moderno (versatile; 2.63 [1.23-5.60]) sexual roles. CONCLUSIONS: Results highlight limitations of current syndromic screening strategies for sexually transmitted diseases in Peru, wherein urethral CT and rectal GC and CT may be missed due to their frequently asymptomatic presentations. Successful management of GC and CT infections among MSM in low-resource settings requires differentiating between bacterial agent, symptomatic presentation, associated risk factors, and public health implications of untreated infection at different anatomic sites. SN - 1537-4521 UR - https://www.unboundmedicine.com/medline/citation/30102262/Body_Parts_Matter:_Social_Behavioral_and_Biological_Considerations_for_Urethral_Pharyngeal_and_Rectal_Gonorrhea_and_Chlamydia_Screening_Among_MSM_in_Lima_Peru_ L2 - https://doi.org/10.1097/OLQ.0000000000000816 DB - PRIME DP - Unbound Medicine ER -