title: Prevalence of Sexually Transmitted Viral and Bacterial Infections in HIV-Positive and HIV-Negative Men Who Have Sex with Men in Toronto.
abstract: BACKGROUND
  Hepatitis B (HBV), hepatitis C (HCV) and other sexually transmitted infections (STIs) have been associated with HIV transmission risk and disease progression among gay men and other men who have sex with men (MSM), but the frequency and distribution of STIs in this community in Canada has not been extensively studied.
  
  
  METHODS
  We recruited MSM living with and without HIV from a large primary care clinic in Toronto. Participants completed a detailed socio-behavioural questionnaire using ACASI and provided blood for syphilis, HIV, HBV and HCV, herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), and human cytomegalovirus (CMV) serology, urine for chlamydia and gonorrhea, and a self-collected anal swab for human papillomavirus (HPV) molecular diagnostics. Prevalences were expressed as a proportion and compared using chi-square.
  
  
  RESULTS
  442 MSM were recruited, 294 living with HIV and 148 without. Active syphilis (11.0% vs. 3.4%), ever HBV (49.4% vs. 19.1%), HCV (10.4% vs. 3.4%), HSV-2 (55.9% vs. 38.2%), CMV (98.3% vs. 80.3%) and high-risk (HR) anal HPV (67.6% vs. 51.7%) infections were significantly more common in men living with HIV. Chlamydia and gonorrhea were infrequent in both groups. Regardless of HIV infection status, age and number of lifetime male sexual partners were associated with HBV infection and lifetime injection drug use with HCV infection.
  
  
  CONCLUSIONS
  Syphilis and viral infections, including HBV, HCV, HSV-2, CMV, and HR-HPV, were common in this clinic-based population of MSM in Toronto and more frequent among MSM living with HIV. This argues for the implementation of routine screening, vaccine-based prevention, and education programs in this high-risk population.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Remis
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Juan
authors.initials: J
authors.lastname: Liu
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.|Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.|Maple Leaf Medical Clinic, Toronto, Ontario, Canada.
authors.forename: Mona R
authors.initials: MR
authors.lastname: Loutfy
authors.affiliation: Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada.
authors.forename: Wangari
authors.initials: W
authors.lastname: Tharao
authors.affiliation: Public Health Laboratory-Toronto Public Health Ontario, Toronto, Ontario, Canada.|Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Rebbapragada
authors.affiliation: Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sanja
authors.initials: S
authors.lastname: Huibner
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Maya
authors.initials: M
authors.lastname: Kesler
authors.affiliation: Maple Leaf Medical Clinic, Toronto, Ontario, Canada.
authors.forename: Roberta
authors.initials: R
authors.lastname: Halpenny
authors.affiliation: Maple Leaf Medical Clinic, Toronto, Ontario, Canada.|Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Troy
authors.initials: T
authors.lastname: Grennan
authors.affiliation: Maple Leaf Medical Clinic, Toronto, Ontario, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Brunetta
authors.affiliation: Maple Leaf Medical Clinic, Toronto, Ontario, Canada.
authors.forename: Graham
authors.initials: G
authors.lastname: Smith
authors.affiliation: Maple Leaf Medical Clinic, Toronto, Ontario, Canada.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Reko
authors.affiliation: Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Rupert
authors.initials: R
authors.lastname: Kaul
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000453:epidemiology*; D002690:Chlamydia Infections / Q000150:complications / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology; D018450:Disease Progression; D006069:Gonorrhea / Q000150:complications / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006561:Herpes Simplex / Q000150:complications / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000150:complications / Q000453:epidemiology; D014777:Virus Diseases / Q000150:complications / Q000453:epidemiology*