The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Tuesday, May 9, 2006 - 10:45 AM

Frequent Detection of Asymptomatic Sexually Transmitted Diseases (STD) among HIV-infected and High Risk HIV-uninfected MSM at a Boston Community Health Center

Kenneth H. Mayer1, Matthew J. Mimiaga2, Donna J. Helms3, Thomas Bertrand4, David Novak5, Chris Grasso6, and Catherine McLean3. (1) Fenway Community Health and Brown University/Miriam Hospital, 7 Haviland Street, Boston, MA, USA, (2) Fenway Community Health and Harvard Medical School, Prudential Tower, 4th Floor, 800 Boylston Street, Boston, MA, USA, (3) Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E-02, Atlanta, GA, USA, (4) STD Director, Massachusetts Dept. of Health, Boston, MA, USA, (5) Massachusetts Department of Public Health, Boston, MA, USA, (6) Fenway Community Health, Boston, MA, USA

Fenway Community Health (FCH) is the largest provider of care for MSM in New England with 27,642 MSM visits from 2002 through 2004. Overall, 1,000 HIV-infected and more than 10,000 HIV-uninfected MSM receive primary care at FCH.

To evaluate the prevalence of specific STDs among men screened for an STD at FCH, comparing HIV-infected with HIV-uninfected men.

The FCH electronic database was reviewed for HIV status and STD test results for all male visits 2002-2004. Data were collected as part of the CDC's MSM Prevalence Monitoring Project. The percent of patients positive for specific STDs and time trends by HIV status were compared using chi-square tests of independence.

In 2002-2004, 8277 men were tested for at least one STD; 25.8% of the tests were done for HIV-infected clients. HIV-infected men were more likely to test positive for an STD than HIV-uninfected men (p<0.0001). Urethral gonorrhea was the most common diagnosis: 17.9% in HIV-infected and 12.0% in HIV-uninfected men (p<0.0001). The percent positive for rectal and pharyngeal gonorrhea, and urethral chlamydial infection, were comparable between HIV-infected and HIV-uninfected men. However, 10.3% of the HIV-infected and 2.5% of the HIV-uninfected men had a reactive syphilis serologic test (p<0.0001). HIV-infected men were more likely to be asymptomatic than HIV-uninfected men at the time of their diagnosis (p<0.001)

STDs were frequently detected among HIV-infected and HIV-uninfected men; Urethral gonorrhea and syphilis seroreactivity were most commonly diagnosed. HIV-infected men more often had an asymptomatic STD, and the overall STD burden was greater in HIV-infected than in HIV-uninfected men.

The ongoing bacterial STD epidemic among New England MSM necessitates new and innovative prevention interventions in order to decrease STD morbidity and avoid further HIV transmission.