Asymptomatic Rectal Bacterial Pathogens Show Large Prospective Relationships With HIV Incidence in a Cohort of Young Sexual and Gender Minorities: Implications for STI Screening and HIV Prevention.

Autor: Baiers RA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA., Ryan DT; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA., Clifford A; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA., Munson E; Medical Laboratory Science, College of Health Sciences, Marquette University, Milwaukee, Wisconsin, USA., D'Aquila R; Department of Medicine-Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Newcomb ME; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Mustanski B; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2024 Aug 05; Vol. 11 (8), pp. ofae444. Date of Electronic Publication: 2024 Aug 05 (Print Publication: 2024).
DOI: 10.1093/ofid/ofae444
Abstrakt: Background: We estimated the predictive value of rectal (bacterial sexually transmitted infection [bSTI]) pathogen detection for future HIV seroconversion among young adult sexual and gender minorities (YSGMs) assigned male at birth (AMAB).
Methods: Data were collected between March 2018 and August 2022 from RADAR, a longitudinal cohort study of YSGMs AMAB living in the Chicago metropolitan area (n = 1022). Rates of rectal bSTIs and the proportion of self-reported rectal bSTI symptoms are reported. We examined whether the presence of rectal bSTIs predicted HIV seroconversion using generalized estimating equations (GEEs).
Results: Participants tested reactive for rectal Mycoplasma genitalium (MGen), Neisseria gonorrhoeae (NG), and Chlamydia trachomatis (CT) at a rate of 20.8 (95% CI, 18.4-23.5), 6.5 (95% CI, 5.0-8.2), and 8.4 (95% CI, 6.8-10.3) cases per 100 persons, respectively. There were no statistically significant pairwise differences in self-reported rectal bSTI symptoms between participants with self-collected swabs testing nonreactive vs reactive for rectal MGen (χ 2 = 0.04; P = .84), NG (χ 2 = 0.45; P = .37), or CT (χ 2 = 0.39; P = .46). In multivariate GEE analysis, rectal NG (adjusted odds ratio, 5.11; 95% CI, 1.20-21.77) was a statistically significant predictor of HIV seroconversion after controlling for other bSTIs, demographics, and sexual risk behavior.
Conclusions: Our findings provide a robust longitudinal estimation of the relationship between primarily asymptomatic rectal NG nucleic acid detection and HIV infection. These findings highlight the importance of asymptomatic screening for bSTIs and targeting biobehavioral intervention to prevent HIV infection among YSGMs with rectal bSTI agents detected.
Competing Interests: Potential conflicts of interest. E.M. has received honoraria and travel grants from Hologic, Incorporated. B.M. has received research support from Hologic, Incorporated.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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