Background Men who have sex with men (MSM) are found to be at increased risk for many sexually transmitted infections (STI). Among the STIs, most common are bacterial STIs such as Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT). In the present study we analysed determinants of repeat gonococcal and chlymadial infections among the cohort of high-risk MSM.
Methods Between 2008 to 2009, 512 MSM attending STI clinics in four clinics of two cities (Mumbai and Hyderabad) of India were recruited and followed for 3 months. First catch urine, rectal swabs, Pharyngeal swabs were collected in all visits and tested for NG and CT by Gen-Probe APTIMA Combo II assay and Roche PCR (Pharyngeal swabs positive by Roche Amplicor and 16s RNA NG PCR were considered). Presumptive treatment for gonorrhoea and chlamydia at the baseline visit and syndromic STI management at all subsequent visits was provided during the study period. Re-infection was defined as a positive test result occurring after 30 days and above after an initial positive result until the last follow-up.
Results Of 417 MSMs recruited during 2008−2009, 454 made at least on fallow-up visit. Three hundred and fifteen were NG infected and 138 were CT infected. 41 (9%) NG and 7 (1.5%) CT re-infections were observed during the follow-up visits see Abstract P1-S2.54 Table 1. Past history of STI (as reported by the participants) (OR=2.82, p=0.00) and diagnosis of any STI by Physician (OR=2.24, p=0.05) were significantly associated factors with re-infection.
Conclusions Cumulative incidence of repeat gonococcal infections among MSMs highlight the need of a routine STI screening, prevention counselling, promoting use of consistent condom, laboratory screening and prompt treatment of patients at high risk. These efforts maximally help in avoiding recurrent NG/CT re-infection among high risk MSMs and there partners.