Bacterial Sexually Transmitted Diseases Among American Black Men Who Have Sex with Men: Results From a Six-City Study

Mayer, Kenneth

Wednesday, March 14, 2012

Hyatt Exhibit Hall

Kenneth Mayer, MD, The Fenway Institute, Fenway Health, Boston, MA, Lei Wang, PhD, Vaccine and Infectious Disease Division, Statistical Center for HIV AIDS Research Programs, Seattle, WA, Vanessa Cummings, MT, BS, HIV Specialty Lab, Johns Hopkins University, Baltimore, MD, Hong VanTieu, MD, Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute New York Blood Center, New York, NY, Manya Magnus, PhD, School of Public Health and Health Services, George Washington University, Washington, DC, Sharon Mannheimer, MD, Division of Infectious Diseases / Harlem Hospital, Columbia University College of Physicians and Surgeons, New York, NY, Charlotte Gaydos, DrPH, School of Medicine, Division of Infectious Diseases, STD Laboratory, Johns Hopkins University, Baltimore, MD, Ting-Yuan Liu, MS, in, Statistics, Statistical Center for HIV/AIDS Research & Prevention (SCHARP), University of Washington, Seatte, WA, Leo Wilton, PhD, MA, Departments of Human Development and Africana Studies -Binghamton University, Binghamton University, Binghamton, NY, Susan Buchbinder, MD, HIV Research, San Francisco Department of Health, San Francisco, CA and Susan Eshleman, MD, PhD, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD

Background: Bacterial STDs have been increasing among MSM, with disproportionate rates detected among Black MSM (BMSM).

Objectives: To determine the sociodemographic and behavioral factors associated with increased STD prevalence in BMSM in order to enhance the efficacy of prevention interventions.

Methods: HPTN 061 recruited 1,555 BMSM in six U.S. cities in 2010-11. The men underwent socio-behavioral and clinical evaluations to assess STD and HIV risk, and to develop appropriate prevention interventions. The present analysis focuses on factors associated with detection of rectal or urethral gonorrhea (GC), chlamydia (CT), and syphilis at the baseline visit.

Results: The median age of the men was 39 years (range: 18 to 68); 60% reported annual household income < $20,000; 30% identified as exclusively homosexual or gay, 15% did not identify as male; 37% reported using substances during sex; 43% reported depressive symptoms (using CESD≤16). The prevalence of STDs was: rectal GC: 3.5%, urethral GC: 1.3%, rectal CT: 6.4%, urethral CT: 2.0%, syphilis: 2.8%. Diagnosis of GC was associated with age <30 years (adjusted odds ratio (AOR)=5.2, p<0.001), HIV-infection (AOR=4.1, p<0.001), having an annual household income of >$50,000 (AOR=3.9, p=0.003), and not self-identifying as male (AOR=2.1, p=0.032). CT diagnosis was associated with age <30 (AOR=4.0, p<0.001), HIV infection (AOR=2.3, p=0.001), not self-identifying as male (AOR=1.9, p=0.021), not using substances during sex (AOR=2.2, p=0.012), and reporting depression (AOR=1.7, p=0.022). Syphilis diagnosis was associated with age <30 years (AOR=2.4, p=0.016), HIV infection (AOR=4.5, p=0.002), and having an annual income between $10,000 and $49,999 (AOR=2.5, p=0.031).

Conclusions: Bacterial STD prevalence is high among BMSM. HIV infection and younger age were associated with CT, GC, and syphilis infection. Other factors were associated with only one or two of the pathogens studied, suggesting that there are distinct networks for STD transmission among BMSM.

Implications for Programs, Policy, and Research: Culturally-tailored interventions are needed to decrease the spread of STDs among BMSM.

P128 Bacterial Sexually Transmitted Diseases Among American Black Men Who Have Sex with Men: Results From a Six-City Study