Risk factors for rectal gonococcal infection amidst resurgence in HIV transmission

Sex Transm Dis. 2003 Nov;30(11):813-7. doi: 10.1097/01.OLQ.0000086603.55760.54.


Background: Rectal gonorrhea in men has been increasing in San Francisco since 1995.

Goal: The goal was to determine behavioral risk factors associated with rectal gonorrhea (RGC) among men who have sex with men (MSM) by HIV serostatus.

Study design: All men reporting receptive anal sex in the last 6 months are screened for RGC, regardless of reported condom use, at San Francisco's municipal sexually transmitted disease (STD) clinic. We surveyed a convenience sample of men screened for RGC at the clinic.

Results: Among 564 MSM surveyed, 7.1% had RGC. HIV-positive MSM were significantly more likely (relative risk, 3.5, 95% confidence interval, 1.9-5.8) to have RGC. Behavioral risks for RGC infection varied significantly by HIV serostatus. HIV-positive MSM engaging in anonymous sex were at highest risk for RGC infection. Drug use during anal sex was the strongest risk factor for RGC infection among HIV-negative or unknown HIV status MSM.

Conclusion: Our data suggest that STD and HIV prevention efforts among MSM in San Francisco must consider the role that HIV serostatus plays in acquisition of new infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Disease Outbreaks*
  • Gonorrhea / epidemiology*
  • Gonorrhea / etiology
  • HIV Infections*
  • Homosexuality, Male
  • Humans
  • Male
  • Middle Aged
  • Neisseria gonorrhoeae
  • Prevalence
  • Rectal Diseases / epidemiology*
  • Rectal Diseases / etiology
  • Risk Factors
  • San Francisco / epidemiology
  • Sexual Behavior / statistics & numerical data
  • Substance-Related Disorders