Advertisement

European Journal of Epidemiology

, Volume 22, Issue 11, pp 799–804 | Cite as

Study of partner-related and situational risk factors for symptomatic male urethritis

  • N. Valin
  • A. Flahault
  • F. Lassau
  • M. Janier
  • V. Massari
Urological Diseases

Abstract

During the last decade, the incidence of male urethritis stopped declining in France. Risk factors associated with unprotected intercourse have been extensively studied in men who have sex with men, but not in men in general. The purpose of the study was to determine major risk factors for urethritis among men and to describe the sociodemographic and medical characteristics of this population in 2005. We conducted a prospective case-crossover study of sexual behaviors among men with acute urethritis attending at general practitioners or sexually transmitted infection (STI) clinics in France. Each patient filled out a selfcompleted questionnaire focusing on sociodemographic characteristics, and on sexual behaviors for the month before urethritis onset and for the preceding 3 months. The doctor reported medical information on a separate questionnaire. Between January and September 2005, 121 cases of male urethritis, defined as recent-onset pain on micturition and/or purulent or mucoid discharge, were included. Median age was 33 years, 22.3% were MSM, 55.1% were single, and 72.0% had at least high school education. Conditional logistic regression analysis showed that intercourse with only casual partners or with both casual and steady partners (OR = 2.6, CI 95%: 0.8–8.7, and OR = 8.7, CI 95%: 2.7–28.0), as well as inconsistent condom use (OR = 5.8, CI 95%: 1.7–19.2) significantly increased the risk of male urethritis. STI prevention campaigns should continue to focus on consistent condom use and should not neglect men over 30 years of age.

Keywords

Case-crossover design Sexual behavior Urethritis 

Abbreviations

GP

General practitioners

MSM

Men who have sex with men

MSW

Men who have sex with women

STI

Sexually transmitted infection

Notes

Acknowledgements

The authors are grateful to the general practitioners of the Sentinelles Network and to the clinicians of STI clinics for their collaboration. N V was supported by a fellowship from Fondation pour la Recherche Médicale, France.

References

  1. 1.
    Nicoll A, Hamers F. Are trends in HIV, gonorrhoea, and syphilis worsening in Western Europe? BMJ 2002;324:1324–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Massari V, Dorléans Y, Flahault A. Persistent increase in the incidence of acute male urethritis diagnosed in general practices in France. Br J Gen Pract 2006;56:110–4.PubMedGoogle Scholar
  3. 3.
    Couturier E, Michel A, Janier M, Dupin N, Semaille C. Syphilis surveillance network. Syphilis surveillance in France, 2000–2003. Euro Surveill 2004;9:7–8.Google Scholar
  4. 4.
    Gouëzel P, Simon A, Derouineau J, Janier M, Muller G, Rouvier J, et al. Consultations de dépistage anonyme et gratuit (CDAG), bilan d’activité du VIH, Paris, évolution 1998–2001. Bull Epidémiol Hebdom 2002;43:215–6. http://www.invs.sante.fr/beh/2002/43/beh_43_2002.pdf.
  5. 5.
    Adam, P. Baromètre gay 2000: résultats du premier sondage auprès des clients des établissements gay parisiens. Bull Epidémiol Hebdom 2002; 18: 77–9. http://www.invs.sante.fr/beh/2002/18/beh_18_2002.pdf.
  6. 6.
    Messiah A, Mouret-Fourme E. Sociodemographic characteristics and sexual behavior of bisexual men in France: implication for HIV prevention. The French National Survey on Sexual Behavior Group. Am J Public Health 1995;85:1543–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Seage GR, Holte S, Gross M, Koblin B, Marmor M, Mayer KH, et al. Case-crossover study of partner and situational factors for unprotected sex. J Acquir Immune Defic Syndr 2002;31:432–9.PubMedGoogle Scholar
  8. 8.
    Sizemore JM Jr, Sanders WM, Lackey PC, Ennis DM, Hook EW. Comparison of STD burden and risk among men with and without regular doctors. Sex Transm Dis 2003;30:512–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Sizemore JM Jr, Sanders WM, Lackey PC, Ennis DM, Hook EW. Risk-taking and health-seeking behavior in a men with a history of urethritis: is there a learning curve? Sex Transm Dis 2004;31:225–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Torgal-Garcia J, Martin-Bouyer G, Durrande JB. Sexually transmitted diseases in a French department, 1978. Bull World Health Organ 1981;59:567–73.PubMedGoogle Scholar
  11. 11.
    Maclure M. The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol 1991;133:144–53.PubMedGoogle Scholar
  12. 12.
    Boussard E, Flahault A, Vibert JF, Valleron AJ. Sentiweb: French communicable disease surveillance on the World Wide Web. BMJ 1996;313:1381–4.PubMedGoogle Scholar
  13. 13.
    Xiridou M, Geskus R, De Wit J, Coutinho R, Kretzschmar M. The contribution of steady and casual partnerships to the incidence of HIV infection among homosexual men in Amsterdam. AIDS 2003;17:1029–38.PubMedCrossRefGoogle Scholar
  14. 14.
    Arnot DJ, Manavi K, McMillan A. Characteristics of younger and older men with urethral chlamydial infection. Int J STD AIDS 2006;17:535–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Cook RL, Clark DB. Is there an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sex Transm Dis 2005;32:156–64.PubMedCrossRefGoogle Scholar
  16. 16.
    Messiah A, Bloch J, Blin P. Alcohol or drug use and compliance with safer sex guidelines for STD/HIV infection: results from the French national survey on sexual behavior (ACSF) among heterosexuals. Sex Trans Dis 1998;25:119–24.CrossRefGoogle Scholar
  17. 17.
    Schneede P, Tenke P, Hofstetter AG. Urinary Tract Infection Working Group of the Health Care Office of the European Association of Urology. Sexually transmitted diseases (STDs)-a synoptic overview for urologists. Eur Urol 2003;44:1–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Bradshaw CS, Tabrizi SN, Head TRH, et al. Etiologies of nongonococcal urethritis:bacteria, viruses, and the association with orogenital exposure. J Infect Dis 2006;193(1):336–5.PubMedCrossRefGoogle Scholar
  19. 19.
    Viboud C, Boelle PY, Kelly J, Auquier A, Schlingmann J, Roujeau JC, et al. Comparison of the statistical efficiency of case crossover and case control designs: Application to severe cutaneous adverse reactions. J Clin Epidemiol 2001;54:1218–27.PubMedCrossRefGoogle Scholar
  20. 20.
    Dosemeci M, Wacholder S, Lubin JH. Does nondifferential misclassification of exposure always bias a true effect toward the null value? Am J Epidemiol 1990;132:746–8.PubMedGoogle Scholar
  21. 21.
    Spira A, Bajos N. Les comportements sexuels en France. La Documentation Française;1993.Google Scholar
  22. 22.
    James NJ, Bignell CJ, Gillies PA. The reliability of self-reported sexual behaviour. AIDS 1991;5:333–6.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • N. Valin
    • 1
    • 2
  • A. Flahault
    • 1
    • 2
    • 3
  • F. Lassau
    • 4
  • M. Janier
    • 4
  • V. Massari
    • 1
    • 2
  1. 1.INSERM U707Paris cedex 12France
  2. 2.Université Pierre et Marie Curie-Paris 6 ParisFrance
  3. 3.AP-HP, Hôpital Tenon, Service de Santé PubliqueParisFrance
  4. 4.AP-HP, Hôpital Saint Louis, Centre clinique et biologique des MSTParisFrance

Personalised recommendations