Prevalence of Mycoplasma genitalium and other sexually transmitted pathogens in male urethritis in a sexual health centre in New Caledonia.

BACKGROUND: The prevalence of sexually transmitted infections (STIs) is high in New Caledonia (NC), but there are no data on Mycoplasma genitalium (MG). However, the syndromic treatment of urethritis used in the territory includes a single dose of azithromycin, which could generate resistance in MG. METHODS: We recruited 217 men referred to the Noumea public medical centre (CMP) with signs of urethritis and meeting the inclusion criteria from May 2016 to March 2018. Each was tested for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV) and for the first time in NC for MG by polymerase chain reaction (PCR). RESULTS: The prevalence of MG was 10.1% (22/217). Azithromycin resistance of MG (mutation in the 23S rRNA gene) could only be assessed for 10 of the 22 strains. Only one (1/10; 10%) was resistant. The prevalence of other STIs tested was high, as CT, NG and/or TV were associated in 77.3% (17/22) of MG-positive cases. CONCLUSIONS: Although co-infections further justify syndromic management, the presence of MG in NC urethritis cases could call treatment guidelines into question.

[Sexual behaviors and acceptability of STI (including HIV) testing outside nightclubs in Saint-Gilles, Reunion]. / Comportements sexuels et acceptabilité du dépistage des IST (dont le VIH) à la sortie de discothèques à Saint-Gilles les Bains, île de la Réunion.

The CDAG/CIDDIST centers (CDAG: Free Anonymous Testing Center/CIDDIST: STI Information, Testing and Diagnosis Center) were created in response to the demands of a population at risk of contracting sexually transmitted infections (STIs) wanting to undergo free, anonymous and confidential testing. On the occasion of Sidaction 2010, a study based on a sample of 100 individuals leaving nightclubs in Saint-Gilles (Réunion) was conducted to evaluate the effectiveness of mobile interventions (i.e. measures to promote HIV and STI information, prevention and testing) beyond the confines of CDAG/CIDDIST centers, focusing specifically on at-risk populations. Data were collected on the acceptability of the intervention and HIV/STI testing and on sexual behaviors among the studied population. In addition to STI-related information, participants were offered a more in-depth consultation with a doctor, followed, if necessary, by a test (blood sample). The results show that there was significant interest in the new measures among the population. 77% considered them necessary. 43% intended to come to the information and testing stand for contraceptives. A small proportion of participants (15%) completed the full screening process in situ. In addition, among the studied population (which included individuals with high-risk behaviors), 40% had never undergone HIV testing. The study highlighted various sexual risk behaviors. 69% of the participants engaged in unprotected anal intercourse, including 46% of single people (defined as living alone and not in a stable relationship). The two indicators (i.e. acceptability of local interventions outside CDAG/CIDDIST centers and risk behaviors among the targeted population) suggest the need to pursue "extramural" interventions among targeted populations and to promote them widely.