High prevalence of asymptomatic sexually transmitted infections in HIV-infected men who have sex with men: a stimulus to improve screening.

In Ireland the incidence of sexually transmitted infections (STIs) is steadily increasing while the number of new HIV-diagnoses in men who have sex with men has more than doubled in the past decade. This study investigated the prevalence of STIs in asymptomatic HIV-infected men who have sex with men (MSM) attending a clinic for routine HIV care in the largest HIV-centre in Ireland. Fifty HIV-infected MSM were included in the study (mean age [SD] 38years [9], 66% Irish). Sixteen per cent of HIV-infected MSM screened were diagnosed with a STI. Thirty-eight per cent reported always using condoms while 4% reported never using condoms, 46% used condoms inconsistently and 10% reported no sexual contacts in the preceding 12 months. Recognising the need to optimise STI screening, a pilot self-screening programme was subsequently introduced to our HIV clinic as a quality improvement initiative. Asymptomatic MSM attending for routine HIV care were invited to have an opportunistic STI screen either provider performed or by self-screening. Seventy-one patients were included in the pilot. Sixty-five (92%) opted for self-collected rectal swabs. Ten STIs were detected in eight patients. This study supports guidelines recommending routine screening for STIs in the care of HIV-infected patients and highlights opportunities to provide relevant screening and education interventions targeting unsafe sexual behaviours.

Keaveney S ，Sadlier C ，O'Dea S ，Delamere S ，Bergin C ... -  《-》

Self-screening for Neisseria gonorrhoeae and Chlamydia trachomatis in the human immunodeficiency virus clinic--high yields and high acceptability.

Soni S ，White JA 《-》

Outreach sexual infection screening and postal tests in men who have sex with men: are they comparable to clinic screening?

Men who have sex with men (MSM) have higher rates of poor sexual health. The National Institute for Health and Care Excellence has produced guidance on increasing the uptake of HIV testing to reduce undiagnosed infection in MSM. We report the results of a pilot outreach sexually transmitted infection service using nurse-delivered screening and self-sampled postal testing at a sex on premises venue with comparison made against a sexual health clinic service. Thirty men were included in each group. Users of the nurse-delivered and postal services were older (nurse service median age 57.5 years vs. postal kit service 47 years vs. clinic 35.5 years, p ≤ 0.001). Outreach groups were less likely to have undertaken sexually transmitted infection testing previously than the clinic group (53.3% and 60% vs. 93.3%, p ≤ 0.001). Chlamydia trachomatis and Neisseria gonorrhoeae testing uptake was comparable across groups (nurse outreach 86.6%, 'do it yourself' postal kit 100% vs. clinic 100%, p = 0.032), but uptake for blood tests was lower in the postal kit group (nurse outreach 83.3%, postal kit 53.3% vs. clinic 100%, p ≤ 0.001). No significant difference in active sexually transmitted infection positivity across the groups was observed. This combination outreach screening approach is effective in targeting MSM who use sex on premises venues.

Wood M ，Ellks R ，Grobicki M 《-》

Asymptomatic sexually transmitted infections in HIV-infected men who have sex with men: prevalence, incidence, predictors, and screening strategies.

Rieg G ，Lewis RJ ，Miller LG ，Witt MD ，Guerrero M ，Daar ES ... -  《-》

High prevalence of sexually transmitted infections in HIV-infected men during routine outpatient visits in the Netherlands.

Heiligenberg M ，Rijnders B ，Schim van der Loeff MF ，de Vries HJ ，van der Meijden WI ，Geerlings SE ，Fennema HS ，Prins M ，Prins JM ... -  《-》