High prevalence of asymptomatic sexually transmitted infections in HIV-infected men who have sex with men: a stimulus to improve screening.
In Ireland the incidence of sexually transmitted infections (STIs) is steadily increasing while the number of new HIV-diagnoses in men who have sex with men has more than doubled in the past decade. This study investigated the prevalence of STIs in asymptomatic HIV-infected men who have sex with men (MSM) attending a clinic for routine HIV care in the largest HIV-centre in Ireland. Fifty HIV-infected MSM were included in the study (mean age [SD] 38years [9], 66% Irish). Sixteen per cent of HIV-infected MSM screened were diagnosed with a STI. Thirty-eight per cent reported always using condoms while 4% reported never using condoms, 46% used condoms inconsistently and 10% reported no sexual contacts in the preceding 12 months. Recognising the need to optimise STI screening, a pilot self-screening programme was subsequently introduced to our HIV clinic as a quality improvement initiative. Asymptomatic MSM attending for routine HIV care were invited to have an opportunistic STI screen either provider performed or by self-screening. Seventy-one patients were included in the pilot. Sixty-five (92%) opted for self-collected rectal swabs. Ten STIs were detected in eight patients. This study supports guidelines recommending routine screening for STIs in the care of HIV-infected patients and highlights opportunities to provide relevant screening and education interventions targeting unsafe sexual behaviours.
Graduate Entry Medical School, University of Limerick, Limerick City, Ireland 10095098@studentmail.ul.ie.
S
S
Keaveney
Department of Genitourinary Medicine and Infectious Diseases, St James's Hospital, Dublin, Ireland.
C
C
Sadlier
Department of Genitourinary Medicine and Infectious Diseases, St James's Hospital, Dublin, Ireland.
S
S
O'Dea
Department of Genitourinary Medicine and Infectious Diseases, St James's Hospital, Dublin, Ireland.
S
S
Delamere
Department of Genitourinary Medicine and Infectious Diseases, St James's Hospital, Dublin, Ireland Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
C
C
Bergin
D000328:Adult; D000554:Ambulatory Care Facilities; D058070:Asymptomatic Diseases / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D015995:Prevalence; D011446:Prospective Studies; D058996:Quality Improvement; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D055815:Young Adult
AIDS; Chlamydia (Chlamydia trachomatis); Gonorrhoea (Neisseria gonorrhoeae); HIV; MSM; homosexual; men who have sex with men; screening; sexually transmitted infection