Characteristics Associated with Urethral and Rectal Gonorrhea and Chlamydia Diagnoses in a US National Sample of Gay and Bisexual Men
BACKGROUND:
Gay
and bisexual men are at elevated risk for Neisseria gonorrhoeae and Chlamydia
trachomatis (GC/CT). Rectal GC/CT symptoms may be less obvious than urethral,
increasing opportunities for undiagnosed rectal GC/CT.
METHODS:
A US
national sample of 1071 gay and bisexual men completed urethral and rectal
GC/CT testing and an online survey.
RESULTS:
In total,
6.2% were GC/CT positive (5.3% rectal, 1.7% urethral). We calculated adjusted
(for education, race, age, relationship status, having health insurance, and
income) odds ratios for factors associated with rectal and urethral GC/CT
diagnoses. Age was inversely associated with urethral and rectal GC/CT.
Compared with white men, Latinos had significantly greater odds of rectal
GC/CT. Among men who reported anal sex, those reporting only insertive sex had
lower odds of rectal GC/CT than did men who reported both insertive and
receptive. There was a positive association between rectal GC/CT and number of
male partners (<12 months), the number of anal receptive acts, receptive
condomless anal sex (CAS) acts, and insertive CAS acts. Compared with those who
had engaged in both insertive and receptive anal sex, those who engaged in only
receptive anal sex had lower odds of urethral GC/CT. The number of male
partners (<12 months) was associated with increased odds of urethral GC/CT.
CONCLUSIONS:
Rectal
GC/CT was more common than urethral and associated with some demographic and
behavioral characteristics. Our finding that insertive CAS acts was associated
with rectal GC/CT highlights that providers should screen patients for GC/CT
via a full range of transmission routes, lest GC/CT go undiagnosed.
- 1From the Center for HIV/AIDS Educational Studies and Training, New York, NY.
- Sex Transm Dis. 2016 Mar;43(3):165-71. doi: 10.1097/OLQ.0000000000000410.
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