Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, California, USA.
BMJ Open. 2013 May 28;3(5):e002775. doi: 10.1136/bmjopen-2013-002775.
Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) can facilitate transmission of HIV. Men who have sex with men (MSM) may harbour infections at genital and extragenital sites. Data regarding extragenital GC and CT infections in military populations are lacking. We examined the prevalence and factors associated with asymptomatic GC and CT infection among this category of HIV-infected military personnel.
Cross-sectional cohort study (pilot).
Infectious diseases clinic at a single military treatment facility in San Diego, CA.
Ninety-nine HIV-positive men were evaluated-79% men who had sex with men, mean age 31 years, 36% black and 33% married.
male, HIV-infected, Department of Defense beneficiary.
any symptom related to the urethra, pharynx or rectum.
GC and CT screening results.
Twenty-four per cent were infected with either GC or CT. Rectal swabs were positive in 18% for CT and 3% for GC; pharynx swabs were positive in 8% for GC and 2% for CT. Only one infection was detected in the urine (GC). Anal sex (p=0.04), male partner (OR 7.02, p=0.04) and sex at least once weekly (OR 3.28, p=0.04) were associated with infection. Associated demographics included age <35 years (OR 6.27, p=0.02), non-Caucasian ethnicity (p=0.03), <3 years since HIV diagnosis (OR 2.75, p=0.04) and previous sexually transmitted infection (STI) (OR 5.10, p=0.001).
We found a high prevalence of extragenital GC/CT infection among HIV-infected military men. Only one infection was detected in the urine, signalling the need for aggressive three-site screening of MSM. Clinicians should be aware of the high prevalence in order to enhance health through comprehensive STI screening practices.
淋病奈瑟菌（GC）和沙眼衣原体（CT）可促进 HIV 的传播。男男性行为者（MSM）可能在生殖器和生殖器外部位感染。关于军事人群中生殖器外 GC 和 CT 感染的数据尚缺乏。我们研究了这一 HIV 感染的军人亚群中无症状 GC 和 CT 感染的流行情况及其相关因素。
横断面队列研究（初步研究）。
加利福尼亚州圣地亚哥的一家单一军事治疗机构的传染病诊所。
评估了 99 名 HIV 阳性男性-79%为男男性行为者，平均年龄 31 岁，36%为黑人，33%为已婚。
男性，HIV 感染者，美国国防部受益对象。
任何与尿道、咽或直肠有关的症状。
GC 和 CT 筛查结果。
24%的人感染了 GC 或 CT。直肠拭子 CT 阳性率为 18%，GC 阳性率为 3%；咽拭子 GC 阳性率为 8%，CT 阳性率为 2%。尿液中仅检测到 1 例（GC）感染。肛交（p=0.04）、男性伴侣（OR 7.02，p=0.04）和每周至少一次性行为（OR 3.28，p=0.04）与感染相关。相关的人口统计学因素包括年龄<35 岁（OR 6.27，p=0.02）、非白种人种族（p=0.03）、HIV 诊断后<3 年（OR 2.75，p=0.04）和既往性传播感染（STI）（OR 5.10，p=0.001）。
我们发现 HIV 感染的军人中存在生殖器外 GC/CT 感染的高流行率。尿液中仅检测到 1 例感染，表明需要对 MSM 进行积极的三联生殖器外部位筛查。临床医生应认识到这种高流行率，通过全面的性传播感染筛查实践来增进健康。
