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Association of high-risk sexual behaviours with sexually transmitted infections among men who have sex with men living with HIV
  1. Angelo Roberto Raccagni1,
  2. Andrea Poli2,
  3. Laura Galli2,
  4. Vincenzo Spagnuolo2,
  5. Elena Bruzzesi1,
  6. Camilla Muccini2,
  7. Nicola Gianotti2,
  8. Diana Canetti2,
  9. Ilaria Mainardi1,
  10. Antonella Castagna2,3,
  11. Silvia Nozza2
  1. 1Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
  2. 2Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
  3. 3Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy
  1. Correspondence to Dr Angelo Roberto Raccagni, Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy; raccagni.angelo{at}hsr.it

Abstract

Objectives To explore different sexual behaviours as risk factors for STI among men who have sex with men (MSM) living with HIV.

Methods This is a cross-sectional study on MSM living with HIV followed at the Infectious Diseases Unit of San Raffaele Hospital, Milan, with at least one diagnosis of gonorrhoea, syphilis, chlamydia or anal human papilloma virus (HPV), between July 2016 and February 2021. We conducted a survey on high-risk sexual behaviours with regard to (1) mean number of partners per month, (2) estimated percentage of condom use and (3) most frequent type of sexual intercourse during 2016–2021. Data on these variables were grouped as follows: (1a) ≤5 vs >5, (1b) >10 vs 10, (2a) 0% vs >0%, (2b) ≤50% vs >50%, (2c) 100% vs <100%, (3a) ≥50% vs <50% receptive, (3b) 100% vs <100% insertive, and (3c) 100% vs <100% receptive. A high-risk group was defined as >5 partners, <100% use of condom and ≥50% receptive intercourse. Univariate logistic regressions were applied to assess the association between sexual behaviours and the risk of each STI.

Results Out of 1051 MSM with at least one STI diagnosis, 580 (55%) answered the survey. The risk of chlamydia was lower among individuals with ≤5 partners (≤5 partners vs >5 partners: OR=0.43, 95% CI 0.28 to 0.66, p=0.001) and among those using condoms more frequently (≤50% use of condom vs >50% use of condom: OR=1.55, 95% CI 1.06 to 2.27, p=0.025; 100% vs <100%: OR=0.35, 95% CI 0.20 to 0.59, p=0.001). Individuals using condoms more frequently also had lower risk of gonorrhoea (100% use of condom vs <100% use of condom: OR=0.37, 95% CI 0.17 to 0.79, p=0.011). The risks of chlamydia (OR=3.07, 95% CI 1.92 to 4.90, p<0.001) and gonorrhoea (OR=2.05, 95% CI 1.12 to 3.75, p=0.020) were higher among individuals belonging to the high-risk group.

Conclusions Chlamydia and gonorrhoea are more likely associated with high-risk sexual behaviours than syphilis and anal HPV among MSM living with HIV.

  • Sexual Behavior
  • Homosexuality, Male
  • Gonorrhea
  • Chlamydia Infections
  • HIV

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Footnotes

  • Handling editor Eric PF Chow

  • Presented at This work has been partially presented at the 18th European AIDS Conference, 27–30 October 2021, PE6/2.

  • Contributors SN conceived the study and contributed to the writing of the article. ARR conducted the surveys on sexual behaviours and contributed to the writing of the article. LG performed the statistical analyses and interpretations and contributed to the writing of the article. AP collected clinical data. IM, EB and AC contributed to the interpretation of the results and to the review of the article. VS, CM and NG visited the individuals and contributed to the review of the article. DC visited the individuals and contributed to the interpretation of the results. All authors have read and agreed to the published version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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