title: Prevalence and factors associated with asymptomatic gonococcal and chlamydial infection among US Navy and Marine Corps men infected with the HIV: a cohort study.
abstract: OBJECTIVE
  Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) can facilitate transmission of HIV. Men who have sex with men (MSM) may harbour infections at genital and extragenital sites. Data regarding extragenital GC and CT infections in military populations are lacking. We examined the prevalence and factors associated with asymptomatic GC and CT infection among this category of HIV-infected military personnel.
  
  
  METHODS
  Cross-sectional cohort study (pilot).
  
  
  METHODS
  Infectious diseases clinic at a single military treatment facility in San Diego, CA.
  
  
  METHODS
  Ninety-nine HIV-positive men were evaluated-79% men who had sex with men, mean age 31 years, 36% black and 33% married.
  
  
  METHODS
  male, HIV-infected, Department of Defense beneficiary.
  
  
  METHODS
  any symptom related to the urethra, pharynx or rectum.
  
  
  METHODS
  GC and CT screening results.
  
  
  RESULTS
  Twenty-four per cent were infected with either GC or CT. Rectal swabs were positive in 18% for CT and 3% for GC; pharynx swabs were positive in 8% for GC and 2% for CT. Only one infection was detected in the urine (GC). Anal sex (p=0.04), male partner (OR 7.02, p=0.04) and sex at least once weekly (OR 3.28, p=0.04) were associated with infection. Associated demographics included age <35 years (OR 6.27, p=0.02), non-Caucasian ethnicity (p=0.03), <3 years since HIV diagnosis (OR 2.75, p=0.04) and previous sexually transmitted infection (STI) (OR 5.10, p=0.001).
  
  
  CONCLUSIONS
  We found a high prevalence of extragenital GC/CT infection among HIV-infected military men. Only one infection was detected in the urine, signalling the need for aggressive three-site screening of MSM. Clinicians should be aware of the high prevalence in order to enhance health through comprehensive STI screening practices.
authors.affiliation: Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, California, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Carpenter
authors.forename: Oliver N
authors.initials: ON
authors.lastname: Refugio
authors.forename: Nehkonti
authors.initials: N
authors.lastname: Adams
authors.forename: Kevin P
authors.initials: KP
authors.lastname: O'Brien
authors.forename: Mark D
authors.initials: MD
authors.lastname: Johnson
authors.forename: Harold L
authors.initials: HL
authors.lastname: Groff
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Maves
authors.forename: Mary F
authors.initials: MF
authors.lastname: Bavaro
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Crum-Cianflone
keywords: DADT; MSM; chlamydia; gonorrhea