Significant increase in testing rates for sexually transmissible infections following the introduction of an anal cytological screening program, targeting HIV-positive men who have sex with men

Abstract

To evaluate whether the introduction of an anal cytology screening program (ACSP) targeting HIV-positive men who have sex with men (MSM) affected rates of sexually transmissible infection (STI) testing and detection in an urban HIV outpatient clinic. STI testing was offered as part of an ACSP. Uptake of STI testing and diagnoses were compared before and after the introduction of an ACSP. The number of men undergoing STI testing increased significantly from 67 (20.4%) to 123 (34.8%) (relative risk 1.7, 95% confidence interval (CI) 1.40-2.07), but the increase in the total number of patients with any STI did not achieve significance (from 7 to 11, prevalence ratio 0.86, 95% CI 0.33-2.21). Rates of STI diagnosed in men participating in the ACSP were no different (11.3% v. 7.7%, P=0.557) from those men declining screening. STI testing, when combined with an ACSP in HIV-positive MSM, may lead to an increase in STI testing and increased opportunities for risk reduction interventions. Men participating in an ACSP appear to have similar risk of STIs to those who decline participation in an ACSP. The inclusion of STI testing could potentially enhance the public health benefit of ACSPs.