HIV incidence among men with and those without sexually transmitted rectal infections: estimates from matching against an HIV case registry.

Pathela, P.; Braunstein, S. L.; Blank, S.; Schillinger, J. A.

doi:10.1093/cid/cit437

Cited by 146HIV/AIDS Research and InterventionsHIV, Drug Use, Sexual RiskReproductive tract infections research

HIV incidence among men with and those without sexually transmitted rectal infections: estimates from matching against an HIV case registry.

Pathela, P., Braunstein, S. L., Blank, S., Schillinger, J. A.·2013·Clinical Infectious Diseases

DOI 10.1093/cid/cit437

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Abstract

BACKGROUND: Sexually transmitted bacterial rectal infections are objective markers of HIV risk behavior. Quantifying HIV risk among men who have sex with men (MSM) who have had these infections can inform prevention efforts. We measured HIV risk among MSM who have and those who have not been diagnosed with rectal Chlamydia trachomatis (CT) and/or rectal Neisseria gonorrhoeae (GC). METHODS: HIV incidence among a cohort of 276 HIV-negative MSM diagnosed with rectal CT and/or GC in New York City sexually transmitted disease (STD) clinics was compared to HIV incidence among HIV-negative MSM without these infections. Matches against the citywide HIV/AIDS registry identified HIV diagnoses from STD clinics, and by other providers. Cox proportional hazards models were used to explore factors associated with HIV acquisition among MSM with rectal infections. RESULTS: HIV-negative MSM with rectal infections (>70% of which were asymptomatic) contributed 464.7 person-years of follow-up. Among them, 31 (11.2%) were diagnosed with HIV, of whom 14 (45%) were diagnosed by non-STD clinic providers. The annual HIV incidence was significantly higher among MSM with rectal infections (6.67%; 95% confidence interval [CI], 4.61%-9.35%) than among MSM without rectal infections (2.53%; 95% CI, 1.31%-4.42%). Black race (hazard ratio, 4.98; 95% CI, 1.75-14.17) was associated with incident HIV among MSM with rectal CT/GC. CONCLUSIONS: One in 15 MSM with rectal infections was diagnosed with HIV within a year, a higher risk than for MSM without rectal infections. Such data have implications for screening for rectal STD, and may be useful for targeting populations for risk-reduction counseling and other HIV prevention strategies, such as preexposure prophylaxis.

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Studies have documented the risk for HIV acquisition among MSM within 1 year after infection with rectal gonorrhea or chlamydia (one in 15 men), primary or secondary syphilis (one in 18), and among men with no rectal STI or syphilis infection (one in 53).
“Studies have documented the risk for HIV acquisition among MSM within 1 year after infection with rectal gonorrhea or chlamydia (one in 15 men), primary or secondary syphilis (one in 18), and among men with no rectal STI or syphilis infection (one in 53) (81–83).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [82]
Rectal gonorrhea and chlamydia are associated with HIV infection.
“Rectal gonorrhea and chlamydia are associated with HIV infection (82,207), and men with repeat rectal infections can be at substantially higher risk for HIV acquisition (208).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [82]

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HIV Incidence Among Men With and Those Without Sexually Transmitted Rectal Infections: Estimates From Matching Against an HIV Case Registry. Clin Infect Dis
Pathela, P., Braunstein, S., Blank, S., & Schillinger, J. A. (2016)
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P1-S5.23 HIV incidence and time to diagnosis among men with bacterial rectal infections, New York City, 2008–2010
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007.4 Incident hiv associated with rectal gonorrhoea (gc) and chlamydia (ct) independent of sexual behaviour in men who have sex with men (msm)
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HIV, Rectal Chlamydia, and Rectal Gonorrhea in Men Who Have Sex With Men Attending a Sexually Transmitted Disease Clinic in a Midwestern US City
Turner, A. N., Reese, P. C., Ervin, M., Davis, J. A., Fields, K. S., & Bazan, J. A. (2013) · Sexually Transmitted Diseases · doi:10.1097/olq.0b013e31828fd163 · Cited by 32 · see citing works
Association between rectal gonorrhoea and HIV incidence in men who have sex with men: a meta-analysis
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Authors: Pathela, P., Braunstein, S. L., Blank, S., & Schillinger, J. A.
Affiliations: New York City Department of Health and Mental Hygiene (US)
Centers for Disease Control and Prevention (US)
Corresponding author: Pathela, P.
ORCID: Pathela, P.
Braunstein, S. L.
Blank, S.
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2013-06-25
Volume: 57
Issue: 8
Pages: 1203-1209
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1093/cid/cit437
OpenAlex: W2131211208
Cited by: 146
References: 27
Citations by year: 2026: 3 · 2025: 5 · 2024: 10 · 2023: 8 · 2022: 18 · 2021: 13 · 2020: 6 · 2019: 17 · 2018: 10 · 2017: 19 · 2016: 15 · 2015: 13 · 2014: 7 · 2013: 1
FWCI: 8.75
Type: journal article
Language: en
Open access: closed
Locations: Clinical Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
Funders: New York City Department of Health and Mental Hygiene
Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords: HIV incidence, men who have sex with men, sexually transmitted infections, HIV risk behavior, HIV prevention, Black men, STI screening
MeSH terms: Adult, Ambulatory Care Facilities, Chlamydia Infections, Chlamydia trachomatis, Gonorrhea, Humans, Male, Neisseria gonorrhoeae, New York City, Rectal Diseases, Registries, Retrospective Studies, Sexually Transmitted Diseases, Bacterial, HIV Infections, Homosexuality, Male, Safe Sex, Kaplan-Meier Estimate, Young Adult

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HIV incidence among men with and those without sexually transmitted rectal infections: estimates from matching against an HIV case registry.

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