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P075 STI and HIV infections among MSM reporting exposure to gonorrhea or chlamydia: implications for expedited partner therapy
Open accessAbstract
Background Expedited partner therapy (EPT) is not recommended for U.S. men who have sex with men (MSM), due, in part, to concerns that STI and HIV infections may remain undiagnosed in EPT-treated partners who do not seek medical attention. To estimate how often infections might be missed, we assessed bacterial STI and new HIV diagnoses among MSM presenting as contacts to Chlamydia trachomatis (Ct) or Neisseria gonorrhoeae (GC). Methods MSM attending New York City sexual health clinics are routinely tested for HIV, syphilis, and urogenital and extra-genital Ct and GC. We measured the number and percent of visits, during 2016–2018, with diagnoses of new HIV infection, or alternate/additional bacterial STI, among MSM who had: reported contact to STI, a clinician diagnosis of contact to GC or CT, and no reported contact to syphilis. Results A total of 3,549 MSM had 4,390 visits eligible for analysis. Overall, 14.6% (640/4,390) visits resulted in bacterial STI diagnoses other than those to which exposure was reported. Among MSM-visits for exposure to Ct-only, 12.4% (177/1,430) resulted in GC diagnoses (including 81 rectal GC infections). Syphilis was diagnosed at 4.4% (159/3,652) of visits for Ct or GC exposure (49 primary/secondary, 49 early latent, 61 late latent). Twenty-eight new HIV diagnoses were made (3 acute, 25 non-acute infections); 8 among visits for Ct-only exposure, 20 for GC exposure. Conclusion MSM reporting contact to Ct or GC, have other, concurrent bacterial STI that will be inadequately treated with therapy directed at only the STI to which they report exposure. A substantial number of HIV infections may remain undiagnosed if sex partners to MSM with Ct and GC do not receive HIV testing. Opportunities to offer HIV pre-exposure prophylaxis may also be missed. Our findings support examining and testing MSM exposed to Ct or GC rather than using EPT. Disclosure No significant relationships.
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Studies have reported that 5% of MSM have a new diagnosis of HIV when evaluated as partners of men with gonococcal or chlamydial infections; however, more recent data indicate that, in certain settings, the frequency of HIV infection is much lower.
“Studies have reported that 5% of MSM have a new diagnosis of HIV when evaluated as partners of men with gonococcal or chlamydial infections (133,134); however, more recent data indicate that, in certain settings, the frequency of HIV infection is much lower (135).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [135]
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Experimental — accuracy not yet measuredPublished studies, including recent data regarding extragenital testing, indicated that male partners of MSM with diagnosed gonorrhea or chlamydia might have other bacterial STIs (gonorrhea or syphilis) or HIV.
“Published studies, including recent data regarding extragenital testing, indicated that male partners of MSM with diagnosed gonorrhea or chlamydia might have other bacterial STIs (gonorrhea or syphilis) or HIV (133–135).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [135]
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Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 3,018
Approach to Managing Sex Partners of People with Sexually Transmitted Infections
Hansman, E., & Klausner, J. D. (2023) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2023.02.003 · Cited by 13
Metadata
- Authors
- Schillinger, J., Jamison, K., Slutsker, J., & Blank, S.
- Affiliations
- Centers for Disease Control and Prevention (US)
- New York City Department of Health and Mental Hygiene (US)
- ORCID
- Blank, Susan
- Venue
- Poster presentations
- Publisher
- BMJ Publishing Group Ltd
- Published
- 2019-07
- Pages
- A107.1-A107
- OpenAlex
- W2980590267
- Cited by
- 2
- References
- 0
- Citations by year
- 2023: 1 · 2021: 1
- Type
- conference abstract
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Poster presentations (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Infectious Diseases › Syphilis Diagnosis and Treatment
- Keywords
- expedited partner therapy, men who have sex with men, gonorrhea, chlamydia, HIV infection, bacterial sexually transmitted infections, syphilis, undiagnosed HIV, HIV pre-exposure prophylaxis, rectal gonorrhea, New York City
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