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High levels of undiagnosed rectal STIs suggest that screening remains inadequate among Black gay, bisexual and other men who have sex with men
  1. Ryan J Watson1,
  2. Charlene Collibee2,
  3. Jessica L Maksut3,
  4. Valerie A Earnshaw4,
  5. Katherine Rucinski3,
  6. Lisa Eaton1
  1. 1Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
  2. 2Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  3. 3Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
  4. 4Department of Human Development and Family Sciences, University of Delaware, Newark, Delaware, USA
  1. Correspondence to Dr Ryan J Watson, University of Connecticut, Storrs, Connecticut, USA; ryanwatson{at}


Objective To better understand rectal STI screening practices for Black gay, bisexual and other men who have sex with men (BGBMSM).

Findings Although 15% of BGBMSM lab tested positive for a rectal STI, the majority of these (94%) were asymptomatic. Though all participants reported their status as HIV negative/unknown, 31 of 331 (9.4%) tested positive on HIV rapid tests. Neither condomless anal intercourse nor the number of male sex partners was associated with rectal STI or HIV diagnosis, although rectal STI diagnosis was positively related to testing HIV positive.

Conclusions Findings suggest that substantial numbers of BGBMSM have asymptomatic STIs but are not tested—an outcome that is likely a strong driver of onward HIV acquisition. Therefore, we must address the asymptomatic STI epidemic among GBMSM in order to reduce HIV transmission, as well as temper STI transmission, among this key population.

  • HIV
  • sexual health
  • screening

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  • Handling editor Jamie Scott Frankis

  • Contributors LE designed and carried out original study by selecting study participants and designing/employing surveys. RW, CC and LE analysed and interpreted the data. RW, CC, LE, VE, KR and JLM wrote and edited the manuscript.

  • Funding We acknowledge funding from the National Institutes of Health: LE (R01MH109409, P30AI050409, R34MH115798), JLM and KR (T32AI102623), CC (K01HD097218), VE (K01DA042881) and RW (K01DA047918).

  • Competing interests None declared.

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