Year-end Sale % OFF 
Abstract
Background: Men who have sex with men (MSM) have a higher prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections compared to the rest of the population, often remaining undiagnosed. In Kenya, prevalence of rectal CT and NG infection and NG antimicrobial sensitivity are poorly described. Methods: MSM who reported receptive anal intercourse (RAI) were recruited from an ongoing human immunodeficiency virus acquisition and treatment study in coastal Kenya in 2016-2017. Rectal swabs were collected at two time points 6 months apart to estimate prevalence and incidence of CT/NG infection using a molecular point-of-care assay. Participants positive for CT or NG were treated according to national guidelines. NG culture and antimicrobial susceptibility testing was performed. Participant and risk behaviour characteristics were collected and association with baseline CT/NG prevalence assessed by multivariable regression analysis. Results: Prevalence of CT/NG in 104 MSM was 21.2% (CT 13.5%, NG 9.6%, dual infection 1.9%) at baseline and 25.9% in 81 MSM at follow-up (CT 14.8%, NG 14.8%, dual infection 3.7%). CT/NG incidence was estimated at 53.0 (95% CI, 34.5-81.3) per 100 person-years. Most CT/NG positive participants were asymptomatic: 95.5% at baseline and 100% at follow-up. CT/NG infection was associated with being paid for sex [adjusted odds ratio (aOR)=6.2, 95% CI (1.7-22.9)] and being in formal employment [aOR=7.5, 95% CI (1.1-49.2)]. Six NG isolates were obtained at follow-up; all were susceptible to ceftriaxone and cefixime and all were resistant to penicillin, tetracycline and ciprofloxacin. Conclusions: There is a high prevalence and incidence of asymptomatic rectal CT and NG in MSM reporting RAI in coastal Kenya. MSM who were paid for sex or had formal employment were more likely to be infected with CT/NG suggesting increased risk behaviour during transactional sex. Antimicrobial susceptibility results suggest that current antibiotic choices in Kenya are appropriate for NG treatment.
Highlights
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are curable sexually transmitted infections (STIs) that can have distressing symptoms and complications, though a large proportion remains asymptomatic[1]
Participant characteristics are described in full in Prevalence of CT/NG At baseline, 22 (21.2%, 95% CI 13.8-30.3%) of the 104 Men who have sex with men (MSM) who took part in the study tested positive for CT and/or NG; 10 had NG (9.6%) and 14 had CT (13.5%)- 2 (1.9%) had dual infection
The prevalence of CT and/or NG infection was associated with receiving payment for sex [adjusted odds ratio=6.2, 95% CI (1.7-22.9)] and being in formal employment [aOR=7.5, 95% CI (1.1-49.2)] on multivariable logistic regression (Table 1), in a model controlling for age, having sex with men only or both men and women (MSME or MSMW, respectively), employment status and receiving payment for sex in the previous three months
Summary
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are curable sexually transmitted infections (STIs) that can have distressing symptoms and complications, though a large proportion remains asymptomatic[1]. Men who have sex with men (MSM) are a key population with regards to transmission of STIs. Prevalence of rectal CT and NG infections has ranged as high as 21.7%-27.2% and 13.8%-25.4%, respectively in Italian and Thai MSM communities[3,4]. In Kenya, we have estimated the prevalence of rectal CT and/or NG to be 11.6% in a small sample of 43 human immunodeficiency virus (HIV)-negative adult MSM in the coastal region[10] and 5.2% in HIV-positive and HIV-negative MSM over the age of 18 in the western part of the country[11]. Men who have sex with men (MSM) have a higher prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections compared to the rest of the population, often remaining undiagnosed. Most CT/NG positive participants were asymptomatic: 95.5% at baseline and 100% at
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
