Aim: Reported incidence of HIV infection and infectious syphilis in New Zealand has been increasing in recent years in men who have sex with men (MSM) but there is no recent published data about prevalence of other sexually transmitted infections (STIs) in this group. Therefore we decided to collect data on prevalent STIs and possible risk factors in a sample of MSM presenting to Auckland Sexual Health Service (ASHS).
Method: All MSM presenting to ASHS during the study period were eligible for enrollment. Data on demographics, sexual behaviour, use of recreational drugs and STI diagnoses was collected and entered into a data collection form after verbal consent was obtained.
Results: Eighty-seven men participated in the survey. A third of the men were symptomatic (n=26) and 44% (n=38) were diagnosed with a new STI including 2 with infectious syphilis and 3 with HIV. The Internet (65%) was the most common method used for meeting sex partners (n=55) and 46% of men (n=37) reported use of recreational drugs within the previous 6 months. Sixty percent (n=52) of men reported more than 5 sexual partners within the previous 6 months and 52% were engaging in concurrent sexual partnerships with both casual and regular partners(n=45). Participants were more likely to use condoms for insertive and receptive anal sex with casual than with regular partners (p=0.0004, p=0.005), however a history of consistent condom use did not rule out diagnosis with a new STI or HIV.
Conclusion: There was a high prevalence of STIs (44%) in this sample of MSM presenting to a sexual health clinic. Many were presenting with problems rather than attending for routine screening. Possible explanations for the high STI rate include high rates of concurrent sexual partnerships (52%), lower rates of consistent condom use within relationships and use of recreational drugs. Internet use was a common method for meeting sex partners and offers future potential for health promotion interventions for MSM. STI screening should be regularly offered to sexually active MSM regardless of whether they report consistent condom use.