title: Anal sexually transmitted infections and risk of HIV infection in homosexual men.
abstract: BACKGROUND
  We examined a range of common bacterial and viral sexually transmitted infections as risk factors for HIV seroconversion in a community-based cohort of HIV-negative homosexual men in Sydney, Australia.
  
  
  METHODS
  Detailed information about HIV risk behaviors was collected by interview twice yearly. Participants were tested annually for HIV, anal and urethral gonorrhea and chlamydia, herpes simplex virus types 1 and 2, and syphilis. In addition, they reported annual diagnoses of these conditions and of genital and anal warts.
  
  
  RESULTS
  Among 1427 enrolled participants, 53 HIV seroconverters were identified, giving an incidence of 0.78 per 100 person-years. After controlling for number of episodes of insertive and receptive nonseroconcordant unprotected anal intercourse, there were independent associations with anal gonorrhea (adjusted hazard ratio = 7.12, 95% confidence interval: 2.05 to 24.79) and anal warts (hazard ratio = 3.63, 95% confidence interval: 1.62 to 8.14).
  
  
  CONCLUSIONS
  Anal gonorrhea and anal warts were independently associated with HIV acquisition. The added HIV prevention value of more frequent screening of the anus to allow early detection and treatment of anal sexually transmitted infections in homosexual men should be considered.
authors.affiliation: National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Level 2, 376 Victoria Street, Darlinghurst, New South Wales 2010, Australia. jjin@nchecr.unsw.edu.au
authors.forename: Fengyi
authors.initials: F
authors.lastname: Jin
authors.forename: Garrett P
authors.initials: GP
authors.lastname: Prestage
authors.forename: John
authors.initials: J
authors.lastname: Imrie
authors.forename: Susan C
authors.initials: SC
authors.lastname: Kippax
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.forename: David J
authors.initials: DJ
authors.lastname: Templeton
authors.forename: Anthony
authors.initials: A
authors.lastname: Cunningham
authors.forename: Adrian
authors.initials: A
authors.lastname: Mindel
authors.forename: Philip H
authors.initials: PH
authors.lastname: Cunningham
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Grulich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D006716:Homosexuality / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult