Objectives: To determine the prevalence and clinical associations of M.genitalium in urethral, rectal and pharyngeal specimens collected from men-who-have-sex-with-men (MSM) attending male-only saunas.
Methods: A cross-sectional study of 521 MSM attending six male-only saunas in Melbourne was conducted between October 2001-September 2002. Stored urine and rectal and pharyngeal swabs were tested for M.genitalium by real-time polymerase chain reaction. The prevalence of M.genitalium, and clinical associations were determined.
Results: A high prevalence (12.9%; 95%CI:10.2-15.9%) of STIs was found in MSM. M.genitalium (2.1%;95%CI: 1.1-3.6%) was less common than C.trachomatis (8.1%; 95%CI: 5.9-10.6%, p<0.001), and N.gonorrhoeae (4.8%; 95%CI: 3.2-6.9%, p=0.02). M.genitalium was most likely to be detected as an asymptomatic rectal (1.6%;95%CI: 0.8-3.0%) or urethral infection (0.6%; 95%CI: 0.2-1.6%, p=0.12), but was absent from the pharynx. In comparison, C.trachomatis was more common in the rectum (6.2%;95%CI: 4.3-8.6%) than urethra (1.8%; 95%CI: 0.9-3.2%, p=0.004), and was uncommon in the pharynx (0.6%; 95%CI: 0.1-1.6%). Urethral infection with N.gonorroheae (0.2%; 95%CI: 0.01-1.0%) was rare, but it was as common in the pharynx (2.5%; 95%CI: 1.4-4.2%) as the rectum (2.2%;95% CI: 1.2-3.8%). No significant demographic or behavioural associations with M.genitalium were identified.
Conclusion: M.genitalium was less common than C.trachomatis and N.gonorrhoeae in MSM attending male-only saunas and was most often detected as an asymptomatic rectal or a urethral infection but was absent from the pharynx. To inform STI-screening strategies in MSM, more data are needed to understand how common M.genitalium-infection is in urethral and non-urethral sites in MSM, and how it contributes to clinical symptoms.