Prevalence of pharyngeal and rectal Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in Germany.
OBJECTIVES
To determine the prevalence of pharyngeal and rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) in Germany and describe associations between these infections, sexual practices and other factors to provide an evidence base for screening recommendations.


METHODS
We conducted a cross-sectional study in 22 sentinel sites of sexually transmitted infections across Germany. Pharyngeal and rectal swabs were collected and tested for CT and NG with a nucleic acid amplification test (NAAT). Information on HIV status, number of sex partners and sexual practices was collected and linked to NAAT results.


RESULTS
Overall, 2247 MSM were screened for pharyngeal or rectal CT and NG infections; median age was 34 years (range 16-83). Prevalence of CT was 1.5% in pharyngeal and 8.0% in rectal specimens. Prevalence of NG was 5.5% in pharyngeal and 4.6% in rectal specimens. Local symptoms were reported in 5.1% of pharyngeal and 11.9% of rectal infections. Altogether 90.8% of rectal or pharyngeal infections would remain undetected if only symptomatic cases were tested. Rectal infection was significantly more likely in men reporting multiple partners (2-5 partners, OR=1.85; 6-10 partners, OR=2.10; >11 partners, OR=2.95), men diagnosed with HIV (OR=1.60) and men practising receptive anal intercourse without a condom (OR=1.54). Pharyngeal infection was more likely in men reporting multiple partners (6-10 partners, OR=2.88; >11 partners, OR=4.96), and men diagnosed with HIV (OR=1.78).


CONCLUSIONS
Pharyngeal and rectal infections in sexually active MSM can remain undetected and thus transmissible if swabbing is not offered routinely. Screening should be offered particularly to MSM diagnosed with HIV and MSM reporting multiple partners.
['Dudareva-Vizule|Sandra|S|', 'Haar|Karin|K|', 'Sailer|Andrea|A|', 'Wisplinghoff|Hilmar|H|', 'Wisplinghoff|Fabian|F|', 'Marcus|Ulrich|U|', '|||']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D002690:Chlamydia Infections D002692:Chlamydia trachomatis D003430:Cross-Sectional Studies D005858:Germany D006069:Gonorrhea D018451:Homosexuality, Male D006801:Humans D016015:Logistic Models D008297:Male D008403:Mass Screening D008875:Middle Aged D009344:Neisseria gonorrhoeae D021141:Nucleic Acid Amplification Techniques D010614:Pharynx D015995:Prevalence D012007:Rectum D012725:Sexual Behavior D012747:Sexual Partners D011795:Surveys and Questionnaires
INFECTION SCREENING HIV EPIDEMIOLOGY (GENERAL) SEXUAL HEALTH