Abstract
Rectal gonorrhea and chlamydia infections are associated with significantly increased risk of HIV transmission among gay, bisexual, and other men who have sex with men (MSM). MSM diagnosed with rectal gonorrhea or chlamydia may benefit from pre-exposure prophylaxis (PrEP) for HIV prevention. We analyzed HIV risk perception, PrEP interest, and sexually transmitted infection (STI) test results among MSM presenting to a publicly funded STI clinic from 2014 to 2016. A total of 401 MSM were tested for rectal STIs during the study period: 18% were diagnosed with rectal gonorrhea or chlamydia infection. Patients who perceived themselves to be at medium or high risk for HIV were significantly more likely to express interest in PrEP compared to those who reported low or no perceived risk (OR 1.88, 95% CI 1.13–3.11; p = .014). However, there was no significant difference in perceived HIV risk between those who were diagnosed with a rectal STI and those who were not. Although rectal STIs are a significant risk factor for HIV infection, MSM diagnosed with a rectal STI did not perceive themselves to be at increased risk for HIV infection, indicating a potential barrier to successful PrEP implementation in this population.
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Bauermeister, J. A., Meanley, S., Pingel, E., Soler, J. H., & Harper, G. W. (2013). PrEP awareness and perceived barriers among single young men who have sex with men in the United States. Current HIV Research, 11(7), 520–527.
Bernstein, K. T., Marcus, J. L., Nieri, G., Philip, S. S., & Klausner, J. D. (2010). Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion. Journal of Acquired Immune Deficiency Syndromes, 53(4), 537–543. https://doi.org/10.1097/QAI.0b013e3181c3ef29.
Centers for Disease Control and Prevention. (2016a). Diagnoses of HIV infection in the United States and dependent areas, 2015. HIV Surveillance Report, 27.
Centers for Disease Control and Prevention. (2016b). Sexually transmitted disease surveillance 2015. Atlanta, GA: Author.
Chan, P. A., Glynn, T. G., Oldenburg, C. E., Montgomery, M. C., Robinette, A. E., Almonte, A., … Nunn, A. S. (2016a). Implementation of pre-exposure prophylaxis for HIV prevention among men who have sex with men at a New England sexually transmitted diseases clinic. Sexually Transmitted Diseases, 43(11), 717–723. https://doi.org/10.1097/OLQ.0000000000000514.
Chan, P. A., Robinette, A., Montgomery, M., Almonte, A., Cu-Uvin, S., Lonks, J. R., … Hardy, E. J. (2016b). Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A review of the literature. Infectious Diseases in Obstetrics and Gynecology, 2016, e5758387. https://doi.org/10.1155/2016/5758387.
Cohen, M. S. (2003). HIV and sexually transmitted diseases: lethal synergy. Topics in HIV Medicine, 12(4), 104–107.
Golub, S. A., Gamarel, K. E., Rendina, H. J., Surace, A., & Lelutiu-Weinberger, C. L. (2013). From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care and STDs, 27(4), 248–254. https://doi.org/10.1089/apc.2012.0419.
Grant, R. M., Lama, J. R., Anderson, P. L., McMahan, V., Liu, A. Y., Vargas, L., … Glidden, D. V. (2010). Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New England Journal of Medicine, 363(27), 2587–2599. https://doi.org/10.1056/NEJMoa1011205.
Katz, D. A., Dombrowski, J. C., Bell, T. R., Kerani, R. P., & Golden, M. R. (2016). HIV incidence among men who have sex with men following diagnosis with sexually transmitted infections. Sexually Transmitted Diseases, 43(4), 249–254. https://doi.org/10.1097/OLQ.0000000000000423.
Kowalewski, M. R., Henson, K. D., & Longshore, D. (1997). Rethinking perceived risk and health behavior: a critical review of HIV prevention research. Health Education & Behavior, 24(3), 313–325. https://doi.org/10.1177/109019819702400305.
Lauby, J. L., Bond, L., Eroğlu, D., & Batson, H. (2005). Decisional balance, perceived risk and HIV testing practices. AIDS and Behavior, 10(1), 83–92. https://doi.org/10.1007/s10461-005-9029-7.
McCormack, S., Dunn, D. T., Desai, M., Dolling, D. I., Gafos, M., Gilson, R., … Gill, O. N. (2016). Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): Effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet, 387(10013), 53–60. https://doi.org/10.1016/S0140-6736(15)00056-2.
Molina, J.-M., Capitant, C., Spire, B., Pialoux, G., Cotte, L., Charreau, I., … Delfraissy, J.-F. (2015). On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. New England Journal of Medicine, 373(23), 2237–2246. https://doi.org/10.1056/NEJMoa1506273.
Pathela, P., Braunstein, S. L., Blank, S., & Schillinger, J. A. (2013). HIV incidence among men with and those without sexually transmitted rectal infections: estimates from matching against an HIV case registry. Clinical Infectious Diseases, 57(8), 1203–1209. https://doi.org/10.1093/cid/cit437.
Patton, M. E., Kidd, S., Llata, E., Stenger, M., Braxton, J., Asbel, L., … Weinstock, H. (2014). Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men—STD Surveillance Network, United States, 2010-2012. Clinical Infectious Diseases, 58(11), 1564–1570. https://doi.org/10.1093/cid/ciu184.
Plankey, M. W., Ostrow, D. G., Stall, R., Cox, C., Li, X., Peck, J. A., & Jacobson, L. P. (2007). The relationship between methamphetamine and popper use and risk of HIV seroconversion in the multicenter AIDS cohort study. Journal of Acquired Immune Deficiency Syndromes, 45(1), 85–92. https://doi.org/10.1097/QAI.0b013e3180417c99.
Public Health-Seattle & King County, & Washington State Department of Health. (2015). Pre-exposure prophylaxis (PrEP) implementation guidelines 2015. Seattle, WA: Author.
Purcell, D. W., Johnson, C. H., Lansky, A., Prejean, J., Stein, R., Denning, P., … Crepaz, N. (2012). Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. The Open AIDS Journal, 6, 98–107. https://doi.org/10.2174/1874613601206010098.
Raifman, J., Nunn, A. S., Oldenburg, C. E., Montgomery, M. C., Fogarty, A. E., Almonte, A., … Chan, P. A. (2017). An evaluation of a clinical pre-exposure prophylaxis education intervention among men who have sex with men. Health Services Research. https://doi.org/10.1111/1475-6773.12746.
U.S. Public Health Service. (2014). Preexposure prophylaxis for the prevention of HIV infection in the United States—2014: A clinical practice guideline. Atlanta, GA: Centers for Disease Control and Prevention.
Workowski, K. A., & Bolan, G. A. (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recommendations and Reports, 64(3), 1–138.
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Biello, K.B., Edeza, A., Montgomery, M.C. et al. Risk Perception and Interest in HIV Pre-exposure Prophylaxis Among Men Who Have Sex with Men with Rectal Gonorrhea and Chlamydia Infection. Arch Sex Behav 48, 1185–1190 (2019). https://doi.org/10.1007/s10508-018-1260-1
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DOI: https://doi.org/10.1007/s10508-018-1260-1