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Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru

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Authors
Passaro, R. Colby
Segura, Eddy R.
Perez-Brumer, Amaya
Cabeza, Jeanne
Montano, Silvia M.
Lake, Jordan E.
Sanchez, Jorge
Lama, Javier R.
Clark, Jesse L.
Issue Date
2018-02
Keywords
Gonorrhea
Chlamydia
Screening
Resource-limited
Public Health

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Citation
Body Parts Matter 2018:1 Sexually Transmitted Diseases
Publisher
American Sexually Transmitted Diseases Association
Journal
Sexually Transmitted Diseases
URI
http://hdl.handle.net/10757/622899
DOI
10.1097/OLQ.0000000000000816
Additional Links
http://Insights.ovid.com/crossref?an=00007435-900000000-98289
Abstract
Background Gonorrhea (GC) and chlamydia (CT) disproportionately affect men who have sex with men (MSM), and public health implications vary by anatomic site and bacterial agent. Urethral and rectal GC and CT can increase risk of HIV transmission, while pharyngeal GC may be a reservoir for antimicrobial resistance. To define screening priorities in Latin America, we compare differences in the prevalence and correlates of urethral, pharyngeal, and rectal GC and CT among MSM in Peru. Methods A cross-sectional sample of 787 MSM from Lima was screened between 2012-2014. We described prevalence of urethral, pharyngeal, and rectal GC and CT infection and conducted bivariate analyses of associations with social, behavioral, and biological characteristics. Poisson regression analyses assessed the correlates of each infection at each anatomic site. Results The most commonly symptomatic infection (urethral GC; 42.1%) was the least prevalent (2.4%). The most prevalent infections were rectal CT (15.8%) and pharyngeal GC (9.9%). Rectal CT was the least commonly symptomatic (2.4%) infection, and was associated with younger age (aPR, 95% CI: 0.96, 0.94-0.98), HIV infection (1.46, 1.06-2.02), and pasivo (receptive; 3.59, 1.62-7.95) and moderno (versatile; 2.63, 1.23-5.60) sexual roles. Conclusions Results highlight limitations of current syndromic screening strategies for STDs in Peru, wherein urethral CT and rectal GC and CT may be missed due to their frequently asymptomatic presentations. Successful management of GC and CT infections among MSM in low-resource settings requires differentiating between bacterial agent, symptomatic presentation, associated risk factors, and public health implications of untreated infection at different anatomic sites.
Type
info:eu-repo/semantics/article
Rights
info:eu-repo/semantics/restrictedAccess
Language
eng
Description
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
ISSN
0148-5717
ae974a485f413a2113503eed53cd6c53
10.1097/OLQ.0000000000000816
Scopus Count
Collections
Medicina

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