High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections among HIV-1 negative men who have sex with men in coastal Kenya

Sex Transm Infect. 2010 Nov;86(6):440-1. doi: 10.1136/sti.2010.043224. Epub 2010 Jul 23.

Abstract

Objectives: To assess the burden of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in high-risk HIV-1 negative men who have sex with men (MSM) in Africa.

Methods: Before the start of a pre-exposure prophylaxis trial, HIV-1 negative volunteers were screened for sexually transmitted infection (STI) including CT and NG, using a highly sensitive and specific nucleic acid amplification test. Samples positive for CT by Aptima testing, were evaluated for the presence of lymphogranuloma venereum (LGV) serovars using an in-house PCR assay. All men were asked to submit a urine specimen, and all had a rectal swab collected by a clinician. Men were asked if they had dysuria, urethral or rectal discharge, or rectal pain.

Results: 43 HIV-1 negative MSM were screened, of whom 13 reported sex with men only; the majority (27/43) reported sex work. One volunteer had dysuria and another, rectal pain. Eleven MSM (26%, 95% CI 14% to 41%) had infections with either or both pathogens. Homosexual men had a higher prevalence of any infection than bisexual men (46% vs 17%, p=0.04), and all cases of rectal infections, including one with CT, two with NG and two with CT/NG co-infection. All patients with CT were negative for LGV. One patient with a rectal NG infection reported rectal pain.

Conclusions: A remarkably high burden of STI infection was found among HIV-1 negative MSM. Most (12/13) infections, including three of four rectal NG infections, were subclinical. These findings suggest that high-risk MSM will benefit from effective STI screening in Kenya.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chlamydia Infections / epidemiology*
  • Chlamydia trachomatis
  • Gonorrhea / epidemiology*
  • HIV Seronegativity*
  • HIV-1*
  • Homosexuality, Male / statistics & numerical data*
  • Humans
  • Kenya / epidemiology
  • Male
  • Neisseria gonorrhoeae
  • Prevalence
  • Rectal Diseases / epidemiology
  • Urethral Diseases / epidemiology
  • Young Adult