social desirability bias. Further investigation of the association between M. genitalium infection and high-grade cervical cytology is warranted. Methods We enrolled HIV-negative women who worked in bars, guesthouses and similar facilities in Tanzania and sex workers and bar workers in Uganda, and followed them quarterly for 12 and 18 months, respectively. At each visit, participants were tested for HIV and interviewed about IVP in the past 3 months. We assessed the association between IVP at each follow-up visit and HIV acquisition using Poisson regression in a combined analysis of both cohorts, controlling for potential confounders. Results 1611 participants were enrolled (966 Tanzanians; 645 Ugandans). At enrolment, 92% of Tanzanians and 93% of Ugandans reported ever cleansing inside the vagina (Table 1); the majority who cleansed used soap/soapy water at least once (75% of Tanzanians and 58% of Ugandans). Nearly half (49%) of Ugandans, but only 13% of Tanzanians, reported ever inserting a substance inside the vagina. The most common substances inserted were herbs, petroleum-based jelly, detergents, aerated drinks, honey, and salt. IntravagInal PractIces and HIv acquIsItIon among1472 participants contributed 71 seroconversions/1,780 pyrs. HIV incidence was 3.99/100 pyrs. Incidence was lower among women who reported cleansing in the past 3 months (aRR:0.44, 95% CI: 0.21-0.93). HIV incidence was similar in women cleansing with soap and those not cleansing/cleansing with water only. P3.117Inserting detergent (aRR:3.05, 95% CI: 1.30-7.18) or petroleumbased jelly (aRR:2.52, 95% CI: 1.08-5.89) were associated with HIV incidence. Conclusions Intravaginal cleansing was highly prevalent in both cohorts; however, insertion was more common among Ugandans. Cleansing was not a predictor of HIV in this study, and may be protective; however, some substances used for insertion may be harmful. These rarer and more harmful types of IVP warrant further investigation. Background The prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections men who have sex with men (MSM) and transgender women (TW) in low and middle income countries is poorly understood. As part of a large intervention trial to reduce HIV and sexually transmitted infection (STI) incidence among MSM/TW in Lima, Peru, we analysed the baseline pre-intervention prevalences of anal and pharyngeal chlamydial and gonococcal infections as well as risky sexual behaviours. Methods We conducted a cross sectional analysis of 718 MSM/ TW enrolled in the Comunidades Positivas and Enhanced Partner Therapy Trial in 2008. Chlamydia trachomatis and Neisseria gonorrhoeae were tested using APTIMA ® Combo2 in pharyngeal swabs and self-collected anal swabs. Based on very low rates found in a pilot study, urethral testing was not undertaken. Behavioral surveys were also conducted using Computer-assisted self interviews. Results In anorectum and oropharynx, the prevalence of Chlamydia trachomatis infection was 19% (95% CI: 16.1%-22.0%) and 4.8% (95% CI: 3.3%-6.6%) respect...

Poster presentations Background To examine the associations between social characteristics of US states and the presence of laws authorising expedited partner therapy (EPT). Methods Data were collected from various sources for 2008-2010 on US state healthcare system characteristics (adult enrollment in Medicaid, number of physicians per 100,000), governmental characteristics (the size of state legislatures, percent of state residents in poverty, percent state financial contribution to state STD programme), and state STD morbidity (chlamydia rates per 100,000 among females age 15-24). Data were analysed in an adjusted logistic regression model in SAS. Results Overall, 23 states have passed legislation authorising EPT as of February 2013. In adjusted analyses, the only healthcare system variable significantly associated with the presence of a state law authorising EPT was higher adult Medicaid enrollment (AOR = 7.871 [95% CI: 1.644, 37.685]), which may represent an increased willingness to authorise EPT where publicly-funded healthcare coverage is more widely available. The only other variable significantly associated with the presence of a law authorising EPT was lower chlamydia rates per 100,000 among females age 15-24 (AOR = 0.332 [95% CI: 0.122, 0.903]). The presence of a state law authorising EPT did not differ by the size of the state legislature, percent in poverty, percent state contribution to state STD programme, or number of physicians per 100,000. Conclusions States with higher adult Medicaid enrollment and lower chlamydia rates among females 15-24 were more likely to have a law authorising EPT. Increased adult Medicaid enrollment may represent an increased willingness of a state to provide publicly-funded healthcare services to its residents; the legal acceptability of EPT may thus be associated with general willingness to provide publicly-funded healthcare within a jurisdiction. This may translate to increased social compatibility of laws authorising EPT in non-US jurisdictions characterised by high rates of publiclyfunded healthcare. Evaluating thE imPact of Short tErm financial incEntivES on hiv and Sti incidEncE among Youth in lESotho: a randomiSEd trial

seroreactivity. Estimates were weighted by the inverse of the participant social network size.

gonococcal porA pseudogene and multi-copy opa genes. Cycle threshold (Ct) values obtained were used as semi-quantitative measures of gonococcal DNA. Sampling adequacy was assessed using a real-time PCR for human endogenous retrovirus 3 (ERV3). Results 100 MSM with culture positive pharyngeal gonorrhoea were included. Isolation rates by culture from the tonsils and posterior oropharynx were 62% and 52% respectively (p = 0.041). PCR was significantly more sensitive than culture at both the tonsils (84% vs. 62%; p < 0.001) and oropharynx (81% vs. 52%; p < 0.001). Culture positivity was greater with higher gonococcal DNA loads at both the tonsils (p = 0.001) and oropharynx (p < 0.001). At the oropharynx, higher ERV3 DNA load was associated with improved gonococcal detection using culture (p = 0.013) as well as PCR (p = 0.045). At the tonsils, higher ERV3 DNA load was associated with improved gonococcal detection by PCR (p = 0.040). Conclusion Neisseria gonorrhoeae can be cultured from the tonsils as well as the posterior oropharynx with greater isolation rates where gonococcal loads are higher. While PCR is substantially more sensitive than culture at each site, like culture, PCR is dependent on the adequacy of sampling.