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Introduction: This study aimed to calculate the prevalence of three bacterial sexually transmitted infections (STIs): Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG), in asymptomatic HIV-negative men-who-have-sex-with-men (MSM) attending Western Sydney Sexual Health Centre (WSSHC). The associations between patient-related factors (demographic, behavioural and clinical factors) and the presence/absence of bacterial STI pathogens were investigated. Methods: This study will calculate the prevalence and risk factors using a retrospective cross-sectional approach relying on pre-collected patient data and laboratory testing results. A multivariable logistic regression model was used to analyse the correlations of STIs diagnosis and specific risk factors. Participants were asymptomatic MSM aged 18 years old and over attending the WSSHC Express Clinic and undergoing onsite STIs screening between 1 February and 31 May 2017. Results: A total of 307 asymptomatic MSM were involved in this study where 82 (26.7%) participants were found to have at least one pathogen at one anatomical site. The three most prevalent diagnoses identified were ano-rectal CT, 9.8% (95% CI: 6.5 to 13.0), ano-rectal MG, 9.4% (95% CI: 6.2 to 12.7), and oro-pharyngeal NG, 5.5% (95% CI: 2.9 to 8.1). Asymptomatic STI cases was relatively low in oro-pharyngeal CT, 1.0% (95% CI: 0.04 to 2.3) and urethral NG, 0.3% (95% CI: 0.04 to 2.3). MG was not detected in oro-pharyngeal samples. Co-infections occurred in 15/307 MSM (4.9%), most frequently at ano-rectal sites. A multivariate model demonstrated that MSM who practised more condomless sex (adjusted odds ratio/AOR=2.39, 95% CI: 1.05 to 5.51, p=0.04) and had past STI episodes (AOR=1.92, 95% CI: 1.01 to 3.62, p=0.04) were more likely to have STI diagnosis. Conclusion: Bacterial STIs were common among asymptomatic HIV-negative MSM attending the Express Clinic in WSSHC. Infections affecting ano-rectal sites remained concerning within this population, as high-risk sexual behaviours were still frequently reported. This study also found a high prevalence of MG infection which was previously not considered as a major infection. These results highlight the importance of STI screening strategies for MSM. |
