High prevalence of asymptomatic sexually transmitted infections in HIV-infected men who have sex with men: a stimulus to improve screening

Int J STD AIDS. 2014 Sep;25(10):758-61. doi: 10.1177/0956462414521165. Epub 2014 Jan 30.


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.

Keywords: AIDS; Chlamydia (Chlamydia trachomatis); Gonorrhoea (Neisseria gonorrhoeae); HIV; MSM; homosexual; men who have sex with men; screening; sexually transmitted infection.

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • Asymptomatic Diseases / epidemiology
  • Chlamydia Infections / diagnosis
  • Chlamydia Infections / epidemiology
  • Chlamydia trachomatis / isolation & purification
  • Gonorrhea / diagnosis
  • Gonorrhea / epidemiology
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • HIV Infections / virology
  • Homosexuality, Male / statistics & numerical data*
  • Humans
  • Male
  • Mass Screening / methods
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Neisseria gonorrhoeae / isolation & purification
  • Prevalence
  • Prospective Studies
  • Quality Improvement
  • Sexually Transmitted Diseases / diagnosis*
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / prevention & control
  • Surveys and Questionnaires
  • Young Adult