Prevalence and Risk Factors for Sexually Transmitted Infections in Gay and Bisexual Prostate Cancer Survivors: Results From the Restore-2 Study

Christopher W Wheldon; Elizabeth Polter; B R Simon Rosser; Alex J Bates; Ryan Haggart; Morgan Wright; Darryl Mitteldorf; Michael W Ross; Badrinath R Konety; Nidhi Kohli; Kristine M C Talley; William West; Alexander K Tatum

doi:10.3389/fonc.2022.832508

Prevalence and Risk Factors for Sexually Transmitted Infections in Gay and Bisexual Prostate Cancer Survivors: Results From the Restore-2 Study

Front Oncol. 2022 May 5:12:832508. doi: 10.3389/fonc.2022.832508. eCollection 2022.

Authors

Affiliations

¹ Cancer Health Equity, Education and Research Lab, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States.
² Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
³ Department of Urology, University of Minnesota, Minneapolis, MN, United States.
⁴ Malecare Cancer Support, New York, NY, United States.
⁵ Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States.
⁶ Department of Urology, Rush Medical College, Chicago, IL, United States.
⁷ Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States.
⁸ Adult and Geriatric Health, University of Minnesota School of Nursing, Minneapolis, MN, United States.
⁹ Department of Writing Studies, University of Minnesota, Minneapolis, MN, United States.
¹⁰ Department of Counseling Psychology, Social Psychology, and Counseling, College of Health, Ball State University, Muncie, IN, United States.

Abstract

Background: Equitable cancer survivorship care for gay and bisexual male (GBM) prostate cancer survivors should be responsive to their sexual health needs. Rates of sexually transmitted infections (STIs) are higher among GBM compared to heterosexual men across the lifespan. In addition, evidence suggests that GBM will use a variety of strategies to cope with sexual dysfunction that may increase risk for STIs. The purpose of this study was to determine the prevalence of STIs following prostate cancer treatment among GBM and identify risk factors.

Methods: In 2019, 401 GBM previously treated for prostate cancer were recruited into the Restore-2 Study. They completed a baseline online questionnaire with items assessing STIs diagnosed since being treated for prostate cancer. Any STI diagnoses was regressed on demographic, clinical, and relationship related variables using binary logistic regression.

Results: Forty-five participants (11.4%) were diagnosed with an STI during or following their prostate cancer treatment. The mostly commonly diagnosed STI was syphilis (4.3%), followed by gonorrhoea (2.8%), and chlamydia (2.5%). Four participants were infected with HIV following their prostate cancer treatment. Independent risk factors for STI diagnosis included time since prostate cancer diagnosis (aOR = 1.18; 95% CI: 1.10-1.26), nonmonogamous sexual relationship (aOR = 11.23; 95% CI: 2.11-59.73), better sexual function (aOR = 1.02; 95% CI: 1.01-1.04), penile injection treatment (aOR = 3.28; 95% CI: 1.48-7.29), and multiple sex partners (aOR = 5.57; 95% CI: 1.64-18.96).

Conclusions: GBM prostate cancer survivors are at risk for STIs. Culturally responsive STI prevention should be incorporated into cancer survivorship plans, particularly as men are treated for and regain sexual function over time.

Keywords: STD (sexually transmitted disease); homosexuality; oncology; risky health behaviors; sexuality.