ABSTRACT
BACKGROUND: Rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) are escalating public health concerns. This study aimed to explore (1) the reliability of self-reported sexual positioning as an indicator for rectal CT and NG screening, and (2) factors associated with rectal CT and NG infections in Shenzhen, China. METHODS: A cross-sectional study was conducted in 2 settings in Shenzhen, China, from April 1, 2021, to March 31, 2022. Data on sociodemographic characteristics, sexual behaviors, and basic CT knowledge were collected. Urine and self-collected rectal swabs were collected for CT and NG testing. RESULTS: In total, 195 MSM participated in the study, and 5.1% tested positive for urogenital CT, 29.2% for rectal CT, 1.0% for urogenital NG, and 8.2% for rectal NG. Among those who reported exclusively insertive anal sex, 69.2% of CT infections and 85.7% of NG infections would have remained undetected with urine testing alone. Risk factors for rectal CT infection included engaging in both insertive and receptive anal sex, with a significant association found for coinfection with rectal NG. CONCLUSIONS: Self-reported sexual positioning was found to be an unreliable indicator for CT and NG screening, as a substantial proportion of infections would have remained undetected. The findings suggest that CT and NG screening in China should be offered to all MSM regardless of self-reported sexual positioning, and that the dual CT/NG testing is recommended.
Subject(s)
Chlamydia Infections , Chlamydia trachomatis , Gonorrhea , Homosexuality, Male , Neisseria gonorrhoeae , Self Report , Sexual Behavior , Humans , Male , Gonorrhea/diagnosis , Gonorrhea/epidemiology , Chlamydia Infections/diagnosis , Chlamydia Infections/epidemiology , China/epidemiology , Cross-Sectional Studies , Adult , Neisseria gonorrhoeae/isolation & purification , Chlamydia trachomatis/isolation & purification , Mass Screening , Rectum/microbiology , Young Adult , Risk Factors , Rectal Diseases/microbiology , Rectal Diseases/diagnosis , Rectal Diseases/epidemiology , Sexual and Gender Minorities , Middle Aged , Reproducibility of ResultsABSTRACT
The aim of this study is to assess the HIV/syphilis epidemic among men who have sex with men (MSM) aged <50 years and ≥50 years in Shenzhen, and explore the associated factors of HIV/syphilis co-infections among MSM in Shenzhen, in order to help prevention and intervention programs determine their target sub-group. A serial cross-sectional study was conducted on MSM in Shenzhen city, China from 2009 to 2017. A questionnaire was used to collect demographic characteristics, history of HIV testing, history of blood donation and sexual behaviors. 5 ml of venous blood were collected for syphilis and HIV tests. The overall prevalence of HIV, syphilis, HIV/syphilis co-infection was 9.40%, 18.97%, and 4.91%, respectively. The prevalence of HIV (15.26%), syphilis (27.71%), HIV/syphilis co-infection (9.24%) in aged ≥50 years MSM was significantly higher than aged <50 years MSM (9.15%, 18.59% and 4.72%, respectively). The following factors were found to be significantly associated with HIV/syphilis co-infections (P<0.05): age≥50 years (OR = 1.78, 95% CI = 1.10-2.87), high school or lower (OR = 1.49, 95% CI = 1.10-2.01), monthly income ≤436.2 USD (OR = 1.74, 95% CI = 1.25-2.42), monthly income 436.4-727.2 USD (OR = 1.46, 95% CI = 1.05-2.03), ≥2 anal sex partners in the past 6 months (OR = 1.59, 95% CI = 1.02-2.49), ≥2 oral sex partners in the past 6 months (OR = 1.60, 95% CI = 1.08-2.36), inconsistent condom use during anal sex in the past 6 months (OR = 1.50, 95% CI = 1.11-2.03). We found that aged <50 years and ≥50 years MSM in Shenzhen had a high prevalence of HIV/syphilis infection in a period from 2009 to 2017. Age-specific sexually transmitted diseases education, prevention, and intervention programs for aged ≥50 years MSM should be implemented urgently and integrated interventions of both HIV and syphilis infections on MSM are needed in the future.
