title: Prevalence and Correlates of Chlamydia trachomatis and Neisseria gonorrhoeae by Anatomic Site Among Urban Thai Men Who Have Sex With Men.
abstract: BACKGROUND
  Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection are prevalent among men who have sex with men (MSM) and may infect multiple anatomic sites. We measured site-specific prevalence and correlates of CT and NG infection among Bangkok MSM Cohort Study participants.
  
  
  METHODS
  In April 2006 to November 2010, 1744 men enrolled in the Bangkok MSM Cohort Study. Participants provided historical information and underwent physical examination. Rectal, urethral, and pharyngeal CT and NG screening were performed by nucleic acid amplification and/or culture. Logistic regression was used to identify correlates of site-specific CT, NG, and coinfection.
  
  
  RESULTS
  Among 1743 participants, 19.2% were infected with CT and/or NG. CT, NG, and CT-NG coinfection were detected in 11.6%, 4.6%, and 2.9%, of participants, respectively. Rectal, urethral, and pharyngeal CT infections were detected in 9.5%, 4.5%, and 3.6% of cases. N. gonorrhoeae was present at these sites in 6.1%, 1.8%, and 0.5% of cases. Most infections were asymptomatic (CT: 95.3%, NG: 83.2%). Rectal CT and NG infections were mutually associated (CT: adjusted odds ratio [AOR], 5.4; 95% confidence interval [CI], 3.4-8.7; NG: AOR, 2.4; 95% CI, 1.1-5.2) and independently associated with HIV infection (CT: AOR, 1.6, 95% CI, 1.0-2.4; NG: AOR, 2.0, 95% CI, 1.3-3.1). Numerous behavioral correlates of infection were observed.
  
  
  CONCLUSIONS
  CT and NG infections are highly prevalent among MSM in Bangkok, most frequently affect the rectum, and are most often asymptomatic. Routine screening of asymptomatic MSM for CT and NG infection should include rectal sampling and focus on men with HIV and a history of other sexually transmitted infections.
authors.affiliation: From the *Thailand Ministry of Public Health-Centers for Disease Control and Prevention Collaboration, Nonthaburi, Bangkok, Thailand; †FHI 360-Asia Pacific Regional Office, Bangkok, Thailand; ‡AVRAM Corporation, Miami, FL; §Thai Bureau of AIDS, TB and STD, Department of Communicable Disease Control, Ministry of Public Health, Bangkok, Thailand; ¶Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA; ∥Thai Red Cross Society AIDS Research Center, Bangkok, Thailand; and **Division of Infectious Diseases, Department of Medicine, Oregon Health and Sciences University, Portland, OR.
authors.forename: Jaray
authors.initials: J
authors.lastname: Tongtoyai
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Todd
authors.forename: Wannee
authors.initials: W
authors.lastname: Chonwattana
authors.forename: Sarika
authors.initials: S
authors.lastname: Pattanasin
authors.forename: Supaporn
authors.initials: S
authors.lastname: Chaikummao
authors.forename: Anchalee
authors.initials: A
authors.lastname: Varangrat
authors.forename: Somchai
authors.initials: S
authors.lastname: Lokpichart
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Holtz
authors.forename: Frits
authors.initials: F
authors.lastname: van Griensven
authors.forename: Marcel E
authors.initials: ME
authors.lastname: Curlin
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D060085:Coinfection; D003430:Cross-Sectional Studies; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D021141:Nucleic Acid Amplification Techniques; D010614:Pharynx / Q000382:microbiology / Q000473:pathology*; D015995:Prevalence; D012007:Rectum / Q000382:microbiology / Q000473:pathology*; D012309:Risk-Taking; D013785:Thailand / Q000453:epidemiology; D014521:Urethra / Q000382:microbiology / Q000473:pathology*