Abstract
BackgroundThe incidences of reportable sexually transmitted infections (STI) among men who have sex with men (MSM) have increased since the late 1990 s in Norway. The objectives of our study were to assess factors, associated with recent selected STI among MSM, living in Norway in order to guide prevention measures.MethodsWe conducted a cross-sectional Internet-based survey during 1-19 October 2007 among members of a MSM-oriented Norwegian website using an anonymous questionnaire on demographics, sexual behaviour, drug and alcohol use, and STI. The studied outcomes were gonorrhoea, syphilis, HIV or Chlamydia infection in the previous 12 months. Associations between self-reported selected STI and their correlates were analysed by multivariable Poisson regression. P value for trend (p-trend), adjusted prevalence ratios (PR) with 95% confidence intervals [] were calculated.ResultsAmong 2430 eligible 16-74 years old respondents, 184 (8%) reported having had one of the following: syphilis (n = 17), gonorrhoea (n = 35), HIV (n = 42) or Chlamydia (n = 126) diagnosed in the past 12 months. Reporting Chlamydia was associated with non-western background (PR 2.8 [1.4-5.7]), number of lifetime male partners (p-trend < 0.001), unsafe sex under the influence of alcohol (PR 1.8 [1.1-2.9]) and with younger age (p-trend = 0.002). Reporting gonorrhoea was associated with unrevealed background (PR 5.9 [1.3-26.3]), having more than 50 lifetime male partners (PR 4.5 [1.3-15.6]) and more than 5 partners in the past 6 months (PR 3.1 [1.1-8.8]), while mid-range income was protective (PR 0.1 [0.0-0.6]). Reporting HIV was associated with residing in Oslo or Akershus county (PR 2.3 [1.2-4.6]), non-western background (PR 5.4 [1.9-15.3]), unrevealed income (PR 10.4 [1.5-71.4]), number of lifetime male partners (p-trend < 0.001) and being under the influence of selected drugs during sex in the past 12 months (PR 5.2 [2.7-11.4]). In addition, the frequency of feeling drunk was reversibly associated with HIV.ConclusionsOur study demonstrates different associations of demographic and behavioural factors with different STI outcomes in the study population. Number of lifetime male partners was the most important potential predictor for Chlamydia and HIV. The STI prevention efforts among MSM should focus on Oslo and Akershus, promote safe sex practices and tackle sex-related drug and alcohol use.
Highlights
The incidences of reportable sexually transmitted infections (STI) among men who have sex with men (MSM) have increased since the late 1990 s in Norway
Selected outcomes We focused our analysis on MSM, who reported being diagnosed with any of the following STI in the previous 12 months: gonorrhoea, syphilis, HIV or Chlamydia infection ("selected STI”)
Most respondents reported being ethnic Norwegians (93%) and having university education (58%). Most men stated their sexual orientation as homosexual (86%), 68% reported more than 10 male sexual partners in their life and 65% reported having had intercourse with an anonymous or casual partner in the last 6 months, of which more than a third reported having unprotected anal intercourse (UAI), (Table 3)
Summary
The incidences of reportable sexually transmitted infections (STI) among men who have sex with men (MSM) have increased since the late 1990 s in Norway. Since the mid-1990 s, sexually transmitted infections (STI) among men who have sex with men (MSM) have been reported to be on the rise in many European countries [1] and worldwide [2,3]. Chlamydia is the most common reportable STI in Norway [7] and MSM-specific data are not available, the rate among Norwegian men in 2007 was as high as 368/100 000 person-years. The surveillance system collects only limited information on STI patients and specific knowledge about sexual risk behaviour among MSM living in Norway is very limited. Sampling on the Internet may be more convenient to attract those men, who may be less likely to self-identify as MSM [9]
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