HIV

Is screening for sexually transmitted infections in men who have sex with men who receive non-occupational HIV post-exposure prophylaxis worthwhile?

E Hamlyn¹, J McAllister¹, A Winston^1,2, B Sinclair¹, J Amin², A Carr¹ and D A Cooper^1,2

¹ HIV, Immunology and Infectious Diseases Clinical Services Unit, St Vincent’s Hospital, Sydney, 2010, Australia
² National Centre for HIV Epidemiology and Clinical Research, University for New South Wales, Sydney, 2010, Australia

Correspondence to:
Correspondence to:
Dr Elizabeth Hamlyn
HIV, Immunology and Infectious Diseases Clinical Services Unit, St Vincent’s Hospital, Victoria Street, Sydney, 2010, Australia; liz_hamlyn{at}yahoo.com

Background/aims: Non-occupational HIV post-exposure prophylaxis (NPEP) is routinely prescribed after high risk sexual exposure. This provides an opportunity to screen and treat individuals at risk of concurrent sexually transmitted infections (STI). The aim of this study was to assess the efficacy of an STI screening programme in individuals receiving NPEP.

Methods: STI screens were offered to all individuals receiving NPEP from March 2001 to May 2004. Screen results were compared to type of sexual exposure and baseline patient characteristics.

Results: A total of 253 subjects were screened, representing 85% of the target population. All were men who have sex with men (MSM). Common exposure risks were receptive anal intercourse (RAI) in 61% and insertive anal intercourse (IAI) in 33%. 32 (13%) individuals had one or more STI. The most common STIs were rectal infections with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in 11 (4.5%) and six (2.5%) individuals, respectively. Subjects with rectal CT were significantly more likely to be co-infected with rectal NG (p<0.001). There was no association between the presence of a rectal STI and age or exposure risk. Only six (19%) individuals with an STI were symptomatic at screening.

Conclusion: In this cohort of MSM receiving NPEP, high rates of concomitant STIs are observed highlighting the importance of STI screening in this setting.

Abbreviations: CT, Chlamydia trachomatis; IAI, insertive anal intercourse; MSM, men who have sex with men; NG, Neisseria gonorrhoeae; NPEP, non-occupational HIV post-exposure prophylaxis; RAI, receptive anal intercourse; RPR, rapid plasma reagent; STI, sexually transmitted infections

Keywords: HIV post-exposure prophylaxis; sexually transmitted infections; screening

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