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Original research
Molecular screening in a longitudinal cohort of young men who have sex with men and young transgender women: associations with focus on the emerging sexually transmitted pathogen Mycoplasma genitalium
  1. Erik Munson1,
  2. Ethan Morgan2,
  3. Laura Sienkiewicz3,
  4. Yazmine Thomas3,
  5. Kathleen Buehler4,
  6. Daniel Ryan4,
  7. Antonia Clifford4,
  8. Brian Mustanski4
  1. 1College of Health Sciences, Marquette University, Milwaukee, Wisconsin, USA
  2. 2Ohio State University, Columbus, Ohio, USA
  3. 3Marquette University, Milwaukee, Wisconsin, USA
  4. 4Institute for Sexual and Gender Minority Health and Wellbeing and Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, USA
  1. Correspondence to Dr Brian Mustanski, Institue for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL 60611, USA; brian{at}


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

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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.

  • Patient consent for publication Not required.

  • Ethics approval This study involving human participants received research ethics approval from Northwestern Institutional Review Board #STU00087614.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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