Background/introduction The 2015 BASHH Chlamydia guidelines recommend LGV testing in asymptomatic HIV positive, but not HIV negative, MSM with rectal chlamydia. Despite evidence for serosorting among MSM having condomless sex, up to 16% are unaware of, or have different HIV status to their sex partners. HIV positive MSM may therefore transmit LGV to serodiscordent partners, resulting in higher than expected infection rates in HIV negative MSM.
Aim(s)/objectives To compare rates of asymptomatic and symptomatic LGV in HIV positive and negative MSM attending a sexual health service.
Methods Case notes of individuals with confirmed LGV from 8/6/2015–31/12/2015 were reviewed and data on demographics, symptoms, HIV status and presence of other STIs collected.
Results We identified 105 cases of LGV (79% White; median age 35.3 years). 48 (46%) were HIV negative. 73% of HIV negative and 56% of HIV positive individuals were asymptomatic. 50 patients (47.7%) had one or more other STIs at time of initial LGV diagnosis; 62% were HIV positive. At time of censor, 95% of individuals attending for test of cure had a negative result.
Discussion/conclusion Asymptomatic LGV was identified in 73% of HIV negative individuals which is likely to have been missed had they not been tested at initial chlamydia diagnosis. STIs facilitate onward transmission of HIV and our findings highlight the importance of continuing to recommend regular screening in all MSM regardless of HIV status to identify infections and offer timely treatment. We recommend LGV testing be extended to asymptomatic HIV negative MSM with rectal chlamydia.