Background Detection of sexually transmitted infections (STIs) in HIV-1 positive (+) men is essential to ensure appropriate treatment and to reduce HIV and STI transmission. We evaluated the baseline prevalences of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and high risk human papillomavirus (HR-HPV) infections in HIV-1+ men.
Methods HIV-1(+) men from three southern California (CA) sites (n = 179) and from one New York (NY) site (n = 254) were screened using APTIMA TMA assays (Hologic/Gen-Probe Inc.) for CT, NG, TV, MG, HR-HPV (with HR-HPV genotyping for HPV-16 and HPV-18/45). Specimen types tested (1–3 per subject) were collected between 11/2010 and 9/2012 and included urine for CT(n = 356), NG (n = 357), TV(n = 357), MG(n = 357), throat for CT(n = 86), NG(n = 178), TV(n = 172), MG(n = 179), HR-HPV(n = 172) and rectal for CT(n = 263), NG(n = 263), TV(n = 255), MG (n = 263), HR-HPV (n = 251). Prevalences were calculated by patient and by specimen types.
Results Overall, 218/433 (50.4%) of the subjects were positive for an STI; 6.2% having > 1 STI; 4.9% had 2 STIs (HPV/MG, HPV/CT, HPV/NG, MG/CT, MG/NG, CT/NG), and 1.4% had 3 STIs (HPV/MG/CT, HPV/MG/NG, MG/CT/NG). Pathogen prevalence by specimen site and patient are listed below:
Genotyping of 127 HR-HPV+ specimens determined that 25.2% contained HPV-16; 10.2% HPV-18/45, 6.3% HPV-16 and HPV-18/45, and 58.3% were negative for HPV-16, 18 or 45.
Conclusions The overall high prevalence of STIs, often multiple STIs per individual, suggests the need to expand screening for multiple STIs in all anatomic sites. Rectal specimens demonstrated the most STIs, especially HPV. Mycoplasma, a pathogen that is not usually tested for, was the most common bacterial STI.