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Optimizing Coverage vs Frequency for Sexually Transmitted Infection Screening of Men Who Have Sex With Men.

ABSTRACT: Background:The incidence of bacterial sexually transmitted infections (STIs) in men who have sex with men (MSM) has increased substantially despite availability of effective antibiotics. The US Centers for Disease Control and Prevention (CDC) recommends annual screening for all sexually active (SA) MSM and more frequent screening for high-risk (HR) MSM. The population-level benefits of improved coverage vs increased frequency of STI screening among SA vs HR MSM are unknown. Methods:We used a network transmission model of gonorrhea (NG) and chlamydia (CT) among MSM to simulate the implementation of STI screening across different scenarios, starting with the CDC guidelines at current coverage levels. Counterfactual model scenarios varied screening coverage and frequency for SA MSM and HR MSM (MSM with multiple recent partners). We estimated infections averted and the number needed to screen to prevent 1 new infection. Results:Compared with current recommendations, increasing the frequency of screening to biannually for all SA MSM and adding some HR screening could avert 72% of NG and 78% of CT infections over 10 years. Biannual screening of 30% of HR MSM at empirical coverage levels for annual SA screening could avert 76% of NG and 84% of CT infections. Other scenarios, including higher coverage among SA MSM and increasing frequency for HR MSM, averted fewer infections but did so at a lower number needed to screen. Conclusions:The optimal screening scenarios in this model to reduce STI incidence among MSM included more frequent screening for all sexually active MSM and higher coverage of screening for HR men with multiple partners.

SUBMITTER: Weiss KM

PROVIDER: S-EPMC6814280 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Optimizing Coverage vs Frequency for Sexually Transmitted Infection Screening of Men Who Have Sex With Men.

Weiss Kevin M KM Jones Jeb S JS Anderson Emeli J EJ Gift Thomas T Chesson Harrell H Bernstein Kyle K Workowski Kimberly K Tuite Ashleigh A Rosenberg Eli S ES Sullivan Patrick S PS Jenness Samuel M SM

Open forum infectious diseases 20191025 10

<h4>Background</h4>The incidence of bacterial sexually transmitted infections (STIs) in men who have sex with men (MSM) has increased substantially despite availability of effective antibiotics. The US Centers for Disease Control and Prevention (CDC) recommends annual screening for all sexually active (SA) MSM and more frequent screening for high-risk (HR) MSM. The population-level benefits of improved coverage vs increased frequency of STI screening among SA vs HR MSM are unknown.<h4>Methods</h ...[more]

PMID: 31667198

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Project description:BackgroundHigh rates of sexually transmitted infections (STIs) among men who have sex with men (MSM) have been reported, but there is little research on their STI knowledge. Our study sought to determine participants' characteristics that contribute to either high or low STI knowledge among MSM in Nairobi, Kenya.MethodsWe mobilized MSM aged ≥18 years from Nairobi into a cross-sectional study. To determine their understanding of STIs, a pre-tested structured questionnaire was administered. Knowledge score was generated by summing up the number of responses answered correctly by a participant. We dichotomized scores as "low" and "high", by splitting the group at <12 and ≥12 which was the mean.ResultsA total of 404 participants were interviewed between March and August 2020. The mean age was 25.2 (SD = 6.4) years. Majority were single (80.4%) and Christians (84.2%). All participants had some formal education ranging from primary to tertiary; the majority (92.3%) had secondary education or more. Most (64.0%) were employed and their monthly income ranged from <50->150 USD. Almost all (98.5%) were Kenyans. Of the 404 (90.6%) self-identified as male and (47.5%) reported to be exclusively top partners. Many (39.9%) reported being versatile, while those reporting to be bottom partners were, (12.6%). The last 12 months, (55.4%) of the participants reported having sex with men only and (88.6%) reported to have had multiple sexual partners. Participants scored an average of 12.2, SD 4.5. Multivariable backward elimination logistic regression revealed that participants who had tertiary education (aOR = 0.50, 95% CI 0.32-0.77), a higher income (aOR = 0.40, 95% CI 0.22-0.75) and were engaging in vaginal sex (aOR = 1.86, 95% CI 1.25-2.78) predicted significantly higher odds of high knowledge in the final multivariable model.ConclusionParticipant's knowledge level regarding STIs was low. We recommend health care workers to continue educating patients about STIs.

Dataset Information

Optimizing Coverage vs Frequency for Sexually Transmitted Infection Screening of Men Who Have Sex With Men.

Publications

Optimizing Coverage vs Frequency for Sexually Transmitted Infection Screening of Men Who Have Sex With Men.

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