bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S1.01 Trends in chlamydia and gonorrhoea positivity among heterosexual men and men who have sex with men (MSM) attending a large urban sexual health service in Australia, 2002–2009
Authors: Vodstrcil L , Fehler G , Leslie D , Walker J , Bradshaw C , Hocking J , Fairley C 
Published: July 2011

BackgroundNotifications for Sexually transmitted infections cannot be used to measure changing incidence or prevalence of infection if a substantial proportion of infections are asymptomatic and screening rates are low. This analysis aimed to determine whether chlamydia positivity among heterosexual men and chlamydia and gonorrhoea positivity among men who have sex with men (MSM) have changed over time after adjusting for sexual risk.MethodsComputerised records for men attending a large sexual health clinic between 2002 and 2009 were analysed. Urethral chlamydia positivity in all men, and anal chlamydia and anal and pharyngeal gonorrhoea positivity in MSM was calculated. Logistic regression was used to assess change in positivity over time adjusting for demographic, clinical, and sexual behavioural risk factors. Testing data from the Victorian Infectious Diseases Reference Laboratory (VIDRL) was also included to supplement the MSHC data.Results17769 heterosexual men and 8328 MSM tested for chlamydia and 7133 MSM tested for gonorrhoea between 2002 and 2009. In heterosexual men, 7.37% (95% CI 6.99 to 7.77) were chlamydia positive with positivity increasing by 4% per year (OR 1.04, 95% CI 1.01 to 1.07) in multivariate analysis. In MSM, 3.70% (95% CI 3.30 to 4.14) had a urethral chlamydia infection and 5.36% (95% CI 4.82 to 5.96) had an anal chlamydia infection, but positivity did not change over time. In MSM, 3.05% (95% CI 2.63 to 3.53) tested positive for anal gonorrhoea and 1.83% (95% CI 1.53 to 2.18) for pharyngeal gonorrhoea. Univariate analysis found anal gonorrhoea positivity had decreased (OR 0.93; 95% CI 0.87 to 1.00), but after multivariate analysis adjusting for sexual risk there was no change. Urethral gonorrhoea cases in MSM as a percentage of all MSM tested for gonorrhoea also fell (p<0.001). The gonorrhoea and chlamydia infection rates in MSM from VIDRL supported our clinic findings showing significant declines in anal and pharyngeal gonorrhoea infections over time and a less marked, but also significant, decline in anal chlamydia; however only univariate analysis was possible.ConclusionsThese data suggest that chlamydia prevalence in heterosexual men is rising and chlamydia and gonorrhoea prevalence among MSM is stable or declining. High STI testing rates among MSM in Australia may explain differences in STI trends between MSM and heterosexual men.
P1-S2.43 Behavioural and biological surveillance among man who have sex with man using respondent-driven sampling methodology in Manaus, Amazon, Brazil
Authors: Benzaken A S , Galban E G , Benzaken N S ,   C K, Pinho A , Mello M , Vasquez F , Barros C A , Sansigolo Kerr L R Franco 
Published: July 2011

BackgroundThere is a renewed interest in including men who have sex with men (MSM) in global HIV surveillance. A multicenter study of 10 Brazilian cities was designed to generate a national-level estimate the prevalence of HIV and syphilis among MSM. This abstracts presents the results of one of the participating cities.ObjectivesTo establish a baseline among MSM in Manaus to continuously monitor the prevalence of HIV and syphilis infection, level of knowledge about STI/HIV/AIDS, prevailing sexual attitudes and practices, and frequency of acts of discrimination against MSM.MethodologyA cross-sectional study of 824 MSM (>18 years old) was conducted from October to May 2008 using respondent-driven sampling (RDS)- a chain-link and snowball sampling method that generates probability-based samples and is systematic, so it can be used to develop comparable surveillance data.ResultsThe weighted prevalence obtained with the use of Respondent-Driven Sampling Analysis Tool (RDSAT) software were 6.8% (CI 4.9 to 9.8) for HIV and 4.0% (CI 2.6 to 5.8) for syphilis. A number of participants reported sex with both men and women (47.8% of HIV positive and 56.1% of syphilis cases), while 20% of HIV positive and 30% of syphilis cases classified themselves as gay or homosexual. A previous infection of syphilis was the main predictive variables associated with HIV. The average age of first intercourse was 13.25 (with a range 5−23). This pattern of early sex suggests abuse. Fifty four point five per cent of participants had their first sexual intercourse with men, 42.6% with women, and 2.2% with transvestites. Participants also reported—41% (CI 37 to 47) used condoms in their first relationship, 73.1% (CI 69.7 to 77.2) had at least one casual sex partner during the previous 12  months, 31.6% (CI 27.7 to 35.9) used condoms consistently with casual relationships if they were with men and 15.5% (CI 11.9 to 18.9) with a woman. Nineteen per cent of MSM said they had been the target of direct physical aggression due to their sexual identity, 10% reported being forced to have sex against their will, and over 30% reported being humiliated or disrespected because of their sexual orientation.ConclusionsThe prevalence of HIV and syphilis infection in MSM in the city of Manaus is relatively high. There is substantial discrimination against MSM. The need of specific public policy and awareness campaigns for this vulnerable group is urgent.
P1-S2.44 Trends in STI in MSM visiting Dutch STI centres; does age matter?
Authors: Koedijk F , van Beek P , Koops K , van der Sande M A B ,   On behalf of the Dutch STI centres
Published: July 2011

ObjectivesThis study examined the distribution of selected sexually transmitted infections (STI) in men and men having sex with men (MSM) attending STI clinics in the Netherlands, separately for young (≥25 years) and older (>25 years) MSM.MethodsData from 2004 up to June 2010 from the Dutch national surveillance in the STI centres were used to characterise trends in positivity rate in STI (at least one of the following—chlamydia, gonorrhoea, syphilis or HIV). Logistic regression was used to identify factors associated with STI positivity in both groups.ResultsOlder MSM tested more often positive for STI than younger MSM—21.5% vs 18.4%, respectively (p<0.05). However, in older MSM there was a significant decreasing time trend in STI positivity (from 23% in 2004 to 19% in 2010, p<0.05, abstract P1-S2.44 figure 1), while in young MSM the STI positivity rate remained stable over time. In multivariate analyses for young MSM, non-Dutch MSM tested significantly more often positive (OR 1.4, 95% CI 1.3 to 1.6), as did those with a previous STI (OR 1.9, 95% CI 1.6 to 2.1), known HIV positives (OR 3.1, 95% CI 2.3 to 4.2), sex workers (OR 1.2, 95% CI 1.1 to 1.6) and those with a low socio-economic status (OR 1.5, 95% CI 1.2 to 1.9). In older MSM, also non-Dutch MSM tested significantly more often positive (OR 1.2, 95% CI 1.1 to 1.2), as did those with a previous STI (OR 1.6, 95% CI 1.5 to 1.7), known HIV positives (OR 1.9, 95% CI 1.8 to 2.1) and those with a low socio-economic status (OR 1.2, 95% CI 1.1 to 1.3). In contrast with young MSM, older MSM working as sex workers were at significantly lower risk (OR 0.7, 95% CI 0.6 to 0.9) for testing positive for any STI.ConclusionsYoung MSM are a specific group within total group of MSM, with some risk factors differencing from older MSM. While trends in positivity are decreasing over time in older MSM, they remain stable and high in young MSM. Therefore special attention needs to be paid towards counselling and reaching (specific groups of) young MSM, since they are at high risk for STI acquisition and transmission.
P1-S2.47 Serosorting and sexual risk behaviour during casual sex among MSM - from one-night stands to sex buddies
Authors: Stolte I , Van den Boom W , Sandfort T , Davidovich U 
Published: July 2011

BackgroundAmong HIV-negative men who have sex with men (MSM), any incident of unprotected anal intercourse (UAI) between casual partners is usually regarded as risky for HIV. However, men are increasingly using knowledge of their casual partner's HIV-status to reduce the risk for HIV during UAI (serosorting). Since familiarity between casual partners may lead to higher levels of UAI and serosorting, we examined how often men have UAI and report serosorting with three casual partner types that differ in the degree of familiarity.MethodsWe included 240 HIV-negative men of the Amsterdam Cohort Study among MSM. We distinguished three casual partner types—one-night stand (“met by chance and had sex only once”); multiple-time casual partner (“met by chance and had sex several times”); and sex buddy (“contacted on a regular basis for sex but not considered a steady partner”). Serosorting was defined as UAI with an HIV-negative partner. GEE analyses were performed to examine the association between casual partner type and sexual risk behaviour.Results240 participants accounted for 362 reports of anal intercourse, of which 206 (57%) with one-night stands, 95 (26%) with multiple-time casual partners, and 61 (17%) with sex buddies. The proportion of UAI was 19% (39/206) with one-night stands, 20% (19/95) with multiple-time casual partners, and 34% (21/61) with sex buddies. When performing UAI, 21% (8/39) reported serosorting with one-night stands, 42% (8/19) with multiple-time casual partners, and 52% (11/21) with sex buddies. Analyses revealed that only men with a sex buddy were significantly more likely to have UAI (OR [95% CI] 2.39 [1.39 to 4.09]), but were also more likely to practice serosorting than men with a one-night stand (OR [95% CI] 5.20 [1.20 to 22.52]). No differences were found between the multiple-time casual partner and the other partner types.ConclusionsMen with a sex buddy had more UAI but also reported more serosorting than men with a one-night stand. As a result, the proportion of UAI without serosorting is lower for men with a sex buddy, and therefore men might have less UAI at risk for HIV with this partner type. However, the quality of serosorting with casual partners and hence their protective value against HIV needs to be further established. At this time, we suggest that a distinction between the one-night stand and the sex buddy should be incorporated in future studies as risk behaviour of MSM is significantly different between these partner types.
P1-S2.48 Exponential growth of Lymphogranuloma venereum diagnoses in the UK: Investigation of the largest documented outbreak among men who have sex with men
Authors: Hughes G , Alexander S , Simms I , Conti S , Powers C , Ison C 
Published: July 2011

BackgroundWith over 1500 cases reported, the UK now has the largest documented outbreak of Lymphogranuloma venereum (LGV) among men who have sex with men (MSM). Of particular concern is the recent exponential rise in cases—a third of all cases have been reported since 2010. We investigated the characteristics of this outbreak and specifically whether any factors were associated with the sharp upsurge in cases in 2010.MethodsThe UK LGV Incident Group launched a diagnostic reference service and enhanced surveillance of LGV in the UK in October 2004. All symptomatic patients attending UK GUM clinics who were chlamydia-positive or contacts of positive cases were referred to STBRL in London and later also to the Scottish Bacterial Sexually Transmitted Infections Reference Laboratory in Edinburgh for confirmation. Enhanced LGV surveillance forms were completed by clinicians caring for cases and submitted to the HPA for analysis. An epidemic curve was plotted and the point of exponential growth estimated. The characteristics of cases prior to and during the exponential growth phase were compared.ResultsSince 2003, 1570 LGV cases have been reported in the UK, of which 1268 (81%) had enhanced surveillance forms available. All but 8 (99%) were in MSM and most (77%) were seen in London, Brighton and Manchester. The point of exponential growth was estimated as 1st October 2009. Compared to cases prior to this date, cases in the growth phase were more likely to be older (41% vs 38% aged over 40), to be HIV positive (84% vs 78%), to be HCV antibody positive (27% vs 22%), to report unprotected anal intercourse (UAI) (80% vs 77%) and fisting (19% vs 14%), to present outside London (32% vs 27%), and to have acquired LGV in the UK (91% vs 87%). Overall, median case age was 38, 84% were white and 11% reported they acquired the infection outside the UK, mostly in Western European countries associated with the epidemic. UAI was reported by 78% of cases and at least 50 were identified as re-infections.ConclusionsLGV is becoming endemic in the UK and is characterised by HIV positive MSM involved in dense sexual networks. Although cases associated with the recent upsurge are more geographically widespread, there is no evidence of dispersal among lower risk or HIV negative MSM. LGV control will require intensified awareness raising and outreach among at risk populations. Regression modelling of key variables is underway to investigate and validate these findings.
P1-S2.50 Anal non-L Chlamydia trachomatis infection in men who have sex with men, at l'Actuel, Montreal, Quebec
Authors: Charest L , Thomas R , Trottier B , Boissonnault M , Legault D , Longpré D , Szabo J , Maziade P J , Machouf N 
Published: July 2011

Few cases of sexually transmitted Hepatitis C infection (HCV) in men who have sex with men (MSM) had been reported in the literature.BackgroundThe incidence of genital infection from non-LChlamydia trachomatis(CT) is increasing in the province of Quebec. Traditionally it was more prevalent in young women. In the last few years, CT infection has emerged in men who have sex with men (MSM) group. The objective of this study was to describe anal non-L CT infection in MSM in an HIV-STI clinic in a large urban setting.MethodsRetrospective study of anal non-L CT cases diagnosed at Clinique l'Actuel in 2010. We collected information on age at diagnosis, HIV status, CT serovars, symptoms, mode of transmission and concomitant presence of CT in urine. An anal swab specimen was collected with a TAAN test (BD Probe Tec TM).ResultsFrom 2006 to 2009, we diagnosed respectively 42, 58, 82 and 118 anal non-L CT infection in MSM. In 2010, we diagnosed 154 different anal non-L CT infections in 152 MSM. Patient's age at diagnosis was 33 years (IQR—25−38) from 18 to 70 years. 28% were HIV+ at time of diagnosis. Anal infection was primarily caused by serovars J (35%), G (31%), D (23%), E (10%), F (1%) and C (1%). Among HIV patients the serovars was predominantly J (46%), D (30%) and G (24%). But this difference was not statistically significant. Anal non-L CT infection was detected in asymptomatic patients while screening in 54% of case. 7% of MSM had no symptom but consulted because they were notified by a sexual partner. 39% had symptoms—proctitis (26%), urethritis (11%) or symptom of other STI including syphilis and HIV primary infection (2%). Mode of transmission for the anal infection was not specifically specified in the file of the patients, but 88% reported anal unprotected penetration in the past year, 12 % did not report anal penetration but had mouth to anus contact (rimming) or friction from penis to anus. One patient reports sharing anal toys. Urine CT was positive in 18% of MSM, so those MSM had two infected sites.ConclusionGiven the high rate of positive results, MSM should be screen with a TAAN test for anal CT infection. This screening should be included in the regular follow-up of HIV patients. MSM community should be aware of this emerging infection. Public health authority should focus on developing and promoting new guidelines of screening, access to validated test with identification of serovars.
P1-S2.54 Repeat Gonococcal and chalymadial infections in a cohort of men who have sex with men in India
Authors: Deshpande G R , Risbud A R , Narayanan P , parimi P , Das A 
Published: July 2011

BackgroundMen who have sex with men (MSM) are found to be at increased risk for many sexually transmitted infections (STI). Among the STIs, most common are bacterial STIs such asNeisseria gonorrhoea(NG) andChlamydia trachomatis(CT). In the present study we analysed determinants of repeat gonococcal and chlymadial infections among the cohort of high-risk MSM.MethodsBetween 2008 to 2009, 512 MSM attending STI clinics in four clinics of two cities (Mumbai and Hyderabad) of India were recruited and followed for 3 months. First catch urine, rectal swabs, Pharyngeal swabs were collected in all visits and tested for NG and CT by Gen-Probe APTIMA Combo II assay and Roche PCR (Pharyngeal swabs positive by Roche Amplicor and 16s RNA NG PCR were considered). Presumptive treatment for gonorrhoea and chlamydia at the baseline visit and syndromic STI management at all subsequent visits was provided during the study period. Re-infection was defined as a positive test result occurring after 30 days and above after an initial positive result until the last follow-up.ResultsOf 417 MSMs recruited during 2008−2009, 454 made at least on fallow-up visit. Three hundred and fifteen were NG infected and 138 were CT infected. 41 (9%) NG and 7 (1.5%) CT re-infections were observed during the follow-up visits see Abstract P1-S2.54 Table 1. Past history of STI (as reported by the participants) (OR=2.82, p=0.00) and diagnosis of any STI by Physician (OR=2.24, p=0.05) were significantly associated factors with re-infection.ConclusionsCumulative incidence of repeat gonococcal infections among MSMs highlight the need of a routine STI screening, prevention counselling, promoting use of consistent condom, laboratory screening and prompt treatment of patients at high risk. These efforts maximally help in avoiding recurrent NG/CT re-infection among high risk MSMs and there partners.Abstract P1-S2.54 Table 1Re-infection frequency among cohort of men having sex with men in IndiaVisitsVisit 1Visit 2Visit 3Visit 4TotalNG-Re-infection No re-infection/ Negatives5124353422321521 Re-infected (31 to 292 days)01913941 Total5124543552411562CT-Re-infection No re-infection/Negatives5124513522401555 Re-infected (31 to 291 days)03317 Total5124543552411562
P1-S2.59 Oropharyngeal human papillomavirus (HPV) prevalence and risk factors in men having sex with men (MSM)
Authors: Read T , Vodstrcil L , Tabrizi S , Garland S , Grulich A , Hocking J , Catriona B , Chen M , McCullough M , Fairley C 
Published: July 2011

BackgroundHPV-associated oropharyngeal cancers are becoming more common. We sought to determine the prevalence of, and risk factors for oropharyngeal HPV infection in MSM, and to compare the sensitivity of throat swab, oral rinse and absorbed rinse specimens.MethodsCross-sectional study of 500 MSM (half with HIV infection) attending Melbourne Sexual Health Centre in 2010. Men completed a behavioural questionnaire, provided a self-administered throat swab and a gargled saline sample. Half the saline was absorbed in a tampon, to be suitable for postage. If HPV was present on type-common polymerase chain reaction, it was typed by linear array. ORs for risk factors were calculated by logistic regression.ResultsAt least one type of HPV was found in 74 of 500 men, a prevalence of 14.8% (95% CI 11.7% to 17.9%) and HPV type 16 was found in 2.8% (95% CI 1.4% to 4.3%). Prevalence of any oropharyngeal HPV was 21.9% in HIV-infected men and and 8% in HIV-negative men—univariate OR 3.2 (95% CI 1.8% to 5.8%). The number of oral sex partners in the previous 2 weeks or previous year was not significant. After multivariate analysis, HIV status was no longer significant. But smoking, older age or higher numbers of reported lifetime oral sex partners all remained significant (Abstract P1-S2.59 table 1).Abstract P1-S2.59 Table 1Adjusted OR95% CIpHIV+1.70.9 to 3.30.11smoker1.81.0 to 3.10.03Age <30Age 30–401.60.7 to 3.60.25Age >402.51.1 to 5.60.03Oral sex partners: <20 during lifetime20–1002.41.1 to 5.20.03>1003.51.6 to 7.50.002ConclusionsOropharyngeal HPV was more than twice as prevalent in HIV-infected MSM as in HIV-negative MSM, likely due to confounding by older age and higher numbers of lifetime sexual partners in this group.
P1-S2.61 High HIV rates among men who have sex with men in Jamaica despite increased prevention efforts
Authors: Figueroa J P , Weir S , Cooper C J , Byfield L , Eastman S , Hobbs M , Duncan J 
Published: July 2011

BackgroundAdult HIV prevalence in Jamaica is 1.7% while rates among men who have sex with men (MSM) were 32% in a 2007 survey. Following this survey prevention interventions among MSM were increased. The objective of this study was to estimate HIV rates among MSM in 2011 and compare findings with the 2007 survey.MethodsAn experienced research nurse attended prevention workshops for MSM as well as their social activities and invited MSM to participate in a cross sectional survey. MSM were interviewed and tested for HIV and other STIs. Sensitive behavioural data was interviewer administered and self-completed. Confidential results were given to participants with treatment as indicated. Ethical approval and informed consent was obtained. The 2011 survey is ongoing so results are preliminary.Results33% of 157 MSM were HIV positive in 2011 compared with 32% of 201 MSM in 2007. In 2011, 8 of 157 (5.1%) MSM were positive for syphilis and 3.8% were indeterminate. 12 of 139 MSM (8.9%) were positive for Chlamydia and 2 (1.4%) had gonorrhoea. In 2007 HIV positive MSM were more likely to ever have a STI (37.5% vs 19.0%, p=0.004) and to be receptive (73.4% vs 59.1%, p=0.005). 33% of MSM reported sex with a woman in the past 4  weeks and 65% reported ever having sex with a woman. Nearly 60% of HIV positive MSM had not disclosed their status to their partner. MSM who were of low socio-economic status, ever homeless and victims of physical violence were significantly more likely to be HIV positive.ConclusionsHIV prevalence among MSM remains unacceptably high. MSM are more socially vulnerable than the general population. Many MSM reported having sex with a woman and not disclosing their HIV status to their partners. MSM are likely to act as a bridge for HIV into the general population. Prevention efforts among MSM need to be scaled up urgently and measures taken to reduce their social vulnerability including stigma and discrimination.Abstract P1-S2.61 Figure 1