High Prevalence of CT/NG Infection in Extragenital Sites Among MSM in Lima, Peru

Leon, Segundo

Tuesday, June 10, 2014

Exhibit Hall

Segundo Leon, MT, MT&ID¹, Kelika A Konda, PhD², Silver K Vargas Rivera, BS³, Juan A Flores, Msc(c) Bioch. & Mol. Biology³, Lottie Romero, MD⁴, Hugo Sanchez, Clinical Psychologist⁵, H. Javier Salvatierra, MD⁶, Brandon Brown, MPH, PhD⁷, Jeffrey Klausner, MD, MPH⁸ and Carlos F Caceres, MD, MPH, PhD⁹, 1Unit of Health, Sexuality and Human Development, and Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia, Lima, Peru, San Martin de Porres, Peru, 2Department of Medicine Division of Infectious Diseases, UCLA, Lima, Peru, 3Unit of Health, Sexuality and Human Development, and Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia, Lima, Peru, 4Unit of Health, Sexuality and Human Development, School of Public Health, San Martin de Porres, Peru, 5Epicentro Salud, Lima, Peru, 6Asociación Civil Impacta Salud y Educación, Lima, Peru, 7UC Irvine Program in Public Health, Irvine, CA, 8Division of Infectious Diseases and Program in Global Health, David Geffen School of Medicine and Fielding School of Public Health, Los Angeles, CA, 9Universidad Peruana Cayetano Heredia, Lima, Peru

Background: Chlamydia trachomatis (CT) and Neisseria Gonorrhoeae(NG) are among the most common STIs worldwide. In Peru, routine screening and testing for CT and NG is lacking as syndromic management for urogenital infections is used. Pharyngeal and anal CT and NG infections may represent an unrecognized burden limiting effective STI control these in Peru

Methods: We conducted a cross-sectional, clinic-based study with high-risk men who have sex with men (MSM) and transgender women (TW) in Lima, Peru and screened them for pharyngeal and anal CT and NG infection (CT/NG Aptima Combo2, GenProbe-Hologic, San Diego, CA) using self-collected anal and pharyngeal swabs. Participants with positive results received treatment based on Peruvian and US-CDC guidelines. Prevalence ratios (PRs) were calculated for associations between socio-demographics, sexual risk behaviors, and infection

Results: We enrolled 133 MSM and 38 TW with a median age of 29.5 years (interquartile range (IQR) 23.4 – 37.9), a median of 5 recent male partners (IQR 2 - 10). Prevalence of CT or NG infection at either anatomical site was 29.8%. Pharyngeal CT and NG infection was 8.8% and 6.5%, respectively, while anal CT and NG infection was 16.3% and 7.6%, respectively. Among CT or NG infected participants, 74.5% had one infection at one anatomical site, 7.8% had the same infection at both sites, and the remaining 17.6% had multiple infections at multiple sites. Pharyngeal CT infection was significantly higher among TW, PR 3.03 (95% CI 1.17 – 7.87). Anal NG infection was significantly associated with younger age, PR 0.93 (95% CI 0.87 – 0.98). No significant associations were found for pharyngeal NG or anal CT infection

Conclusions: Prevalence of pharyngeal and anal CT and NG infections are considerable among high-risk Peruvian MSM/TW. In accordance with WHO guidelines for MSM and transgender sexual health, increasing access to CT/NG screening including non-genital sites should be implemented

TP 174 High Prevalence of CT/NG Infection in Extragenital Sites Among MSM in Lima, Peru