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Factors associated with sexually transmitted shigella in men who have sex with men: a systematic review
  1. Mohammed Siddiq1,
  2. Holly O'Flanagan1,
  3. Daniel Richardson1,2,
  4. Carrie D Llewellyn3
  1. 1Brighton and Sussex Medical School, Brighton, UK
  2. 2Department of Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
  3. 3Department of Primary Care & Public Health, Brighton and Sussex Medical School, Brighton, Brighton and Hove, UK
  1. Correspondence to Professor Daniel Richardson, Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton BN2 5BE, UK; docdanielr{at}


Background Outbreaks of sexually transmitted shigella have been reported in men who have sex with men (MSM) since the 1970s and present a major public health issue. Understanding the factors associated with the sexual transmission of shigella may inform future control strategies.

Methods We systematically searched four bibliographical databases (January 2000–February 2022) for manuscripts in English. We used a two-stage process to assess eligibility: the primary author conducted an initial screen and then three authors conducted independent full-text reviews to determine the final eligible manuscripts. We only included manuscripts that included MSM diagnosed with sexually transmitted shigella where specific factors associated with transmission were identified.

Results Thirteen manuscripts met the inclusion criteria that included 547 individuals. Sexually transmitted shigella in MSM was associated with: residing in a capital city/urban region, living with HIV (including engaging in seroadaptive sexual behaviour, having a low CD4 count, having a HIV viral load >100 000 and not engaging with HIV care), using HIV pre-exposure prophylaxis, use of geospatial mobile phone applications to meet sexual partners, visiting sex on premises venues, chemsex and recreational drug use, sexual behaviour (including multiple non-regular sexual partners and oral-anal sexual contact) and concomitant STIs.

Conclusion We have highlighted some important risk behaviours and factors that are associated with sexually transmitted shigella in MSM that can be used to target future shigella control interventions.

  • Homosexuality, Male

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  • Handling editor Jason J Ong

  • Twitter @cdllewellyn1

  • Contributors DR and CL designed this study. MS performed the initial search; MS, HO’F and DR performed the final selection. MS and DR performed the narrative synthesis; all authors contributed to the final 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.