Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion.
Abstract
INTRODUCTION: HIV infection continues to disproportionately affect men who have sex with men (MSM). Identification of modifiable risk factors for HIV infection among MSM is critical for effective prevention. METHODS: We examined the relationship between number of prior rectal Neisseria gonorrhoeae (GC) or Chlamydia trachomatis (CT) infections and HIV seroconversion in a retrospective cohort of HIV-uninfected MSM diagnosed with a rectal infection. Number of rectal CT or GC infections in the prior 2 years was the primary exposure. Univariate and multivariate Cox proportional hazards models were used to estimate the association between prior rectal infections and HIV seroconversion. RESULTS: A total of 541 MSM were observed for a total of 1197.96 person-years. Overall, 27 (4.99%) of the MSM became infected with HIV, for an estimated annual incidence of 2.25% [95% confidence interval (CI): 1.49 to 3.26]. In multivariate analysis, an early syphilis diagnosis in the past 2 years (hazard ratio = 4.04, 95% CI: 1.19 to 13.79) and 2 prior CT or GC rectal infections in the past 2 years (hazard ratio = 8.85, 95% CI: 2.57 to 30.40) were associated with incident HIV. CONCLUSIONS: Among MSM infected with rectal GC or CT, a history of 2 additional prior rectal infections was associated with an 8-fold increased risk of HIV infection. HIV-uninfected MSM with multiple rectal infections represent a population in need of innovative HIV-prevention interventions.
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Men with repeat rectal infections can be at substantially higher risk for HIV acquisition.
“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 [208]
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Self-citation
- Authors
- Bernstein, K. T., Marcus, J. L., Nieri, G., Philip, S. S., & Klausner, J. D.
- Affiliations
- San Francisco Department of Public Health (US)
- Corresponding author
- Bernstein, Kyle T
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2010-04-01
- Volume
- 53
- Issue
- 4
- Pages
- 537-543
- ISSN
- 1525-4135 (ISSN-L)
- OpenAlex
- W1976513589
- Cited by
- 360
- References
- 44
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 18 · 2023: 16 · 2022: 20 · 2021: 29 · 2020: 38 · 2019: 32 · 2018: 25 · 2017: 31 · 2016: 26 · 2015: 27 · 2014: 30 · 2013: 16 · 2012: 11
- FWCI
- 9.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention (1h25ps001354-01)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- HIV seroconversion, rectal gonorrhea, Neisseria gonorrhoeae, Chlamydia trachomatis, men who have sex with men, reinfection, early syphilis, HIV prevention, risk factors
- MeSH terms
- Adult, Chlamydia Infections, Gonorrhea, HIV Seropositivity, Humans, Male, Middle Aged, Rectal Diseases, Retrospective Studies, Risk Factors, Incidence, Young Adult
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