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2020-02-07Zeitschriftenartikel DOI: 10.25646/6572
STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany
dc.contributor.authorJansen, Klaus
dc.contributor.authorSteffen, Gyde
dc.contributor.authorPotthoff, Anja
dc.contributor.authorSchuppe, Ann-Kathrin
dc.contributor.authorBeer, Daniel
dc.contributor.authorJessen, Heiko
dc.contributor.authorScholten, Stefan
dc.contributor.authorSpornraft-Ragaller, Petra
dc.contributor.authorBremer, Viviane
dc.contributor.authorTiemann, Carsten
dc.contributor.authorMSM Screening Study group
dc.date.accessioned2020-03-20T08:53:20Z
dc.date.available2020-03-20T08:53:20Z
dc.date.issued2020-02-07none
dc.identifier.other10.1186/s12879-020-4831-4
dc.identifier.urihttp://edoc.rki.de/176904/6540
dc.description.abstractBackground Men who have sex with men (MSM) are disproportionally affected by sexually transmitted infections (STI). STI are often extragenital and asymptomatic. Both can delay diagnosis and treatment. Approval of HIV pre-exposure prophylaxis (PrEP) might have influenced sexual behaviour and STI-prevalence of HIV- MSM. We estimated STI-prevalence and risk factors amongst HIV- and HIV+ MSM in Germany to plan effective interventions. Methods We conducted a nationwide, cross-sectional study between February and July 2018. Thirteen MSM-friendly STI-practices screened MSM for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhea (NG), and Trichomonas vaginalis (TV) using self-collected rectal and pharyngeal swabs, and urine samples. APTIMA™ STI-assays (Hologic™ Inc., San Diego, USA) were used for diagnostics, and samples were not pooled. We collected information on socio-demographics, HIV-status, clinical symptoms, sexual behaviour within the last 6 months, and PrEP use. We combined HIV status and PrEP use for defining risk groups, and used directed acyclic graphs and multivariable logistic regression to identify risk factors for STI. Results Two thousand three hundred three MSM were included: 50.5% HIV+, median age 39 [18–79] years. Median number of male sex partners within the last 6 months was five. Sex without condom was reported by 73.6%, use of party drugs by 44.6%. 80.3% had a STI history, 32.2% of STI+ MSM reported STI-related symptoms. 27.6% of HIV- MSM used PrEP. Overall STI-prevalence was 30.1, 25.0% in HIV−/PrEP- MSM (CT:7.2%; MG:14.2%; NG:7.4%; TV:0%), 40.3% in HIV−/PrEP+ MSM (CT:13.8%; MG:19.4%; NG:14.8%; TV:0.4%), and 30.8% in HIV+ MSM (CT:10.1%; MG:18.4%; NG:8.6%; TV:0.1%). Being HIV+ (OR 1.7, 95%-CI 1.3–2.2), using PrEP (OR 2.0, 95%-CI 1.5–2.7), having > 5 sex partners (OR:1.65; 95%-CI:1.32–2.01.9), having condomless sex (OR:2.11.9; 95%-CI:1.65–2.86), and using party drugs (OR:1.65; 95%-CI:1.32–2.0) were independent risk factors for being tested positive for at least one STI. Conclusions We found a high STI-prevalence in MSM in Germany, especially in PrEP users, frequently being asymptomatic. As a relevant proportion of PrEP users will not use a condom, counselling and comprehensive STI screening is essential and should be low threshold and preferably free of cost. Counselling of PrEP users should also address use of party drugs.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectMSMeng
dc.subjectPrevalenceeng
dc.subjectPrEPeng
dc.subjectHIVeng
dc.subjectChlamydia trachomatiseng
dc.subjectNeisseria gonorrhoeaeeng
dc.subjectMycoplasma genitaliumeng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleSTI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germanynone
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:0257-176904/6540-0
dc.identifier.doihttp://dx.doi.org/10.25646/6572
dc.type.versionpublishedVersionnone
local.edoc.container-titleBMC Infectious Diseasesnone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-4831-4#author-informationnone
local.edoc.container-publisher-nameBioMed Centralnone
local.edoc.container-volume20none
local.edoc.container-issue110none
local.edoc.container-year2020none
local.edoc.container-firstpage1none
local.edoc.container-lastpage14none
local.edoc.rki-departmentInfektionsepidemiologienone
dc.description.versionPeer Reviewednone

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