Background Lymphogranuloma venereum (LGV) is a re-emergent STI that particularly affects HIV-positive men who have sex with men. During enhanced surveillance in the United Kingdom a number of individuals presented with LGV re-infection. Determining reasons for their increased risk is of importance in designing effective interventions. We sought to identify characteristics that might explain re-infection among these men.

Methods Between 2004–2010 the LGV Enhanced Surveillance system collected individual-level cross-sectional data on confirmed LGV episodes. We compared the baseline characteristics of men with repeat LGV episodes to men with a single reported episode and we report univariate logistic regression or Fisher’s exact test where appropriate.

Results In the dataset 1215 individuals had a single reported infection and 62 had a known repeat infection. The mean age was 38 which did not differ between groups. Men with re-infection had higher prevalence of HIV than those with one episode (97% versus 79%, P < 0.001), concurrent hepatitis C (PCR) (19% versus 9%, OR 2.19, 95% CI 1.05, 4.59) and gonorrhoea infection (29% versus 16%, OR 2.16, 95% CI 1.21, 3.84). Repeaters were also more likely to be seen in a clinic in London (81% versus 68%, OR 2.00, 95% CI 1.05, 3.80) and they reported higher levels of unprotected sex including insertive and receptive unprotected sex. However, a high proportion of non-repeaters also reported unprotected sex and the difference was not statistically significant.

Conclusions LGV repeaters display characteristics traditionally attributed to core groups, but behavioural characteristics alone did not explain LGV re-infection among these patients. LGV repeaters have a high prevalence of STI co-infections which is of clinical and epidemiological relevance, and may suggest their position in the sexual network is contributing to the heightened risk for STI acquisition. Further research is needed to ascertain this.