Understanding Recent Increases in the Incidence of Sexually Transmitted Infections in Men Having Sex With Men: Changes in Risk Behavior From Risk Avoidance to Risk Reduction
January 24, 2006
The authors of the current study sought to explore risk behavior and transmission routes in men having sex with men (MSM) newly diagnosed with sexually transmitted infections (STIs).
Physicians participating in the sentinel study completed a questionnaire on clinical diagnosis and manifestation site for acute STIs, while patients contributed information on sexual risk behavior and likely STI transmission route.
Of the 356 diagnosis forms and 169 matching patient questionnaires analyzed, syphilis was the most frequent diagnosis (n=147; 33 percent primary syphilis with ulcer localization, 71 percent genital, 22 percent anorectal, and 8 percent oral; 67 percent secondary syphilis), followed by gonorrhea (n=136; 59 percent genital, 34 percent rectal, 7 percent pharyngeal) and Chlamydia trachomatis infection (n=51; 48 percent genital, 48 percent rectal, 4 percent pharyngeal). More than one infection was diagnosed in 12 patients, and two or three sites were affected in 11 patients. About 60 percent of STIs were acquired by genital-oral and oral-anal practices. Unprotected anal intercourse (UAI) was reported more frequently by HIV-positive men (mostly receptive) and MSM with high numbers of partners.
"High partner numbers, an important role of genital-oral sexual practices for the transmission of STIs, and relatively high frequencies of mostly receptive UAI in HIV-positive men are all contributing to increasing STI incidences among MSM," the researchers concluded.
Sexually Transmitted Diseases
01.06.06; Vol. 33; No. 1: P. 11-17; Ulrich Marcus, M.D.; Viviane Bremer, M.D., M.P.H.; Osamah Hamouda, M.D., M.P.H.; Michael H. Kramer, M.D., M.P.H.; Matthias Freiwald; Heiko Jessen, M.D.; Michael Rausch, M.D.; Bernd Reinhardt; Alex Rothaar, M.D.; Wolfgang Schmidt, M.D.; Yves Zimmer, M.D.; other members of the MSM-STD-Sentinel Network
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.