title: HIV, rectal chlamydia, and rectal gonorrhea in men who have sex with men attending a sexually transmitted disease clinic in a midwestern US city.
abstract: BACKGROUND
  Men who have sex with men (MSM) who report receptive anal intercourse (RAI) are currently recommended to undergo at least annual screening for rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infection.
  
  
  METHODS
  Using standard culture methods, we assessed the prevalence of rectal GC/CT among MSM who reported RAI in the last year (n = 326) at an urban sexually transmitted disease (STD) clinic in a midwestern US city. A subset (n = 125) also underwent rectal GC/CT screening via nucleic acid amplification testing. We examined the associations between HIV status and prevalence of rectal GC and rectal CT using unadjusted and adjusted logistic regression models.
  
  
  RESULTS
  The prevalence of rectal GC, rectal CT, and either rectal infection was 9%, 9%, and 15% by culture and 24%, 23%, and 38% by nucleic acid amplification testing, respectively. HIV was not associated with rectal GC prevalence in unadjusted or adjusted analyses. HIV-positive status was significantly associated with increased rectal CT prevalence in unadjusted models (odds ratio, 2.18; 95% confidence interval, 1.04-4.60); this association increased after multivariable adjustment (odds ratio, 3.14; 95% confidence interval, 1.37-7.19).
  
  
  CONCLUSIONS
  Men who have sex with men reporting RAI had a high prevalence of rectal GC and rectal CT. HIV-positive status was significantly associated with prevalent rectal CT but not with prevalent rectal GC.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Ohio State University, OH 43210, USA. ant@osumc.edu
authors.forename: Abigail Norris
authors.initials: AN
authors.lastname: Turner
authors.forename: Patricia Carr
authors.initials: PC
authors.lastname: Reese
authors.forename: Melissa
authors.initials: M
authors.lastname: Ervin
authors.forename: John A
authors.initials: JA
authors.lastname: Davis
authors.forename: Karen S
authors.initials: KS
authors.lastname: Fields
authors.forename: Jose A
authors.initials: JA
authors.lastname: Bazan
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening; D009820:Ohio / Q000453:epidemiology; D015995:Prevalence; D012002:Rectal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D014505:Urban Population