Background The US National HIV Behavioral Surveillance (NHBS) system conducts venue-based sampling of men who ever had a male sexual partner (MSM). In 2017, NHBS-MSM included testing extragenital specimens for chlamydia (CT) and gonorrhea (GC). These population-based prevalence data could inform differences in STD rates across jurisdictions.
Methods We limited the analysis to San Francisco (SF) participants who consented to STD and HIV testing, and reported oral or anal sex with a man in the past year. We calculated the prevalence of rectal and pharyngeal CT and GC, and examined demographics, self-reported STD testing history and positivity, HIV status, and use of PrEP and condoms. We compared SF STD prevalence and testing history to aggregate preliminary data from the 5 NHBS cities where extragenital testing was conducted (including SF), using a z-test for significance.
Results Over half of SF participants were ages 18–39 (54.8%) and non-Hispanic white (51.0%); 25.5% were Hispanic, 4.5% non-Hispanic black, and 18.6% other. PrEP use was common among SF participants (48.8%); condomless sex was high (88.8%). Compared to national NHBS data, SF participants were more likely to report an STD test (75.7% vs 65.7%, p<0.01), or a positive test for CT (19.8% vs 11.2%, p<0.01) or GC (22.6% vs 14.4%, p<0.01), in the last year. Confirmed HIV-uninfected status was similar (79.0% SF vs 76.5% national). STD prevalence was lower in SF than nationally for any extragenital STD (8.2% vs 13.3%), rectal STD (6.2% vs 10.4%), and pharyngeal STD (4.1% vs 5.9%).
Conclusion NHBS-MSM prevalence of CT and GC was lower in SF than nationally. Higher reported STD testing in the past year and high self-reported PrEP use in SF point to high uptake of routine screening, which could help explain the low prevalence. Further examination of the consenting and positive national and SF NHBS participants might explain these striking differences.
Disclosure No significant relationships.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.