Objectives This investigation sought to characterise risk factors associated with acquisition of traditional and emerging agents of sexually transmitted infection (STI) in a cohort of young men who have sex with men and transgender women.
Methods 917 participants provided urine and rectal swab submissions assessed by transcription-mediated amplification (TMA)-based assays for Chlamydia trachomatis and Neisseria gonorrhoeae and by off-label TMA-based Trichomonas vaginalis and Mycoplasma genitalium testing. A subset provided specimens at 6-month and 12-month follow-up visits.
Results Prevalence of M. genitalium from rectal and urine specimens (21.7% and 8.9%, respectively) exceeded that of C. trachomatis (8.8% and 1.6%) and other STI agents. Black participants yielded higher prevalence of M. genitalium (30.6%) than non-black participants (17.0%; χ²=22.39; p<0.0001). M. genitalium prevalence from rectal specimens was 41.5% in HIV-positive participants vs 16.3% in HIV-negative participants (χ²=57.72; p<0.0001). Participant age, gender identity, condomless insertive anal/vaginal sexual practice and condomless receptive anal sexual practice were not associated with rectal C. trachomatis (p≥0.10), N. gonorrhoeae (p≥0.29), T. vaginalis (p≥0.18) or M. genitalium (p≥0.20) detection. While prevalence of T. vaginalis was calculated at ≤1.0%, baseline rectal and urine screening status was predictive of detection/non-detection at follow-up. A non-reactive M. genitalium baseline rectal or urine screening result was less predictive of non-reactive follow-up versus C. trachomatis, N. gonorrhoeae and T. vaginalis.
Conclusions Rectal M. genitalium detection is associated with black race and HIV seropositivity. Baseline M. genitalium infection influences subsequent detection of the organism.
- sexual health
- gay men
- public health
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Handling editor Claudia S Estcourt
Contributors BM: designing the study, overseeing data collection, writing of the manuscript and review of the manuscript. EM: data generation, writing of manuscript and review of manuscript. EM: writing of the manuscript and review of the manuscript. YT, LS, AC: data generation and review of manuscript. DR, KB: data management and analyses.
Funding This work was supported by grants from the National Institute on Drug Abuse at the National Institutes of Health (U01DA036939, PI: Mustanski; F32DA046313, PI: Morgan).
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The sponsor had no involvement in the conduct of the research or the preparation of the article.
Competing interests EM has received honoraria and travel grants from Hologic, Incorporated. BM has received consulting fees from Hologic, Incorporated.
Provenance and peer review Not commissioned; externally peer reviewed.