Prostate-Specific Antigen is Unlikely to Be a Suitable Biomarker of Semen Exposure From Recent Unprotected Receptive Anal Intercourse in Men Who Have Sex With Men

Exten, Cara; Gallo, Maria; Hobbs, Marcia M.; Lynch, Carl; Norris, Alison; Davis, John A.; Fields, Karen S.; Ervin, Melissa; Turner, Abigail Norris

doi:10.1097/olq.0000000000000129

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Currently, there is no acceptable biomarker for semen exposure in the rectum (e.g. prostate specific antigen testing); 36 , 37 therefore, we were unable to validate self-reported CRAI activity in our cohort. We did not control for diet or other environmental factors in the microbiome analyses, and unmeasured confounding factors may explain the enrichment for Prevotellaceae among MSM.…”

Section: Discussionmentioning

confidence: 93%

The rectal mucosa and condomless receptive anal intercourse in HIV-negative MSM: implications for HIV transmission and prevention

et al. 2017

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Most HIV transmissions among men who have sex with men (MSM), the group that accounted for 67% of new US infections in 2014, occur via exposure to the rectal mucosa. However, it is unclear how the act of condomless receptive anal intercourse (CRAI) may alter the mucosal immune environment in HIV negative MSM. Here, we performed a comprehensive characterization of the rectal mucosal immune environment for the phenotype and production of pro-inflammatory cytokines by CD4 and CD8 T cells, global transcriptomic analyses, and the composition of microbiota in HIV negative MSM. Our results show that compared to men who had never engaged in anal intercourse, the rectal mucosa of MSM engaging in CRAI has a distinct phenotype characterized by higher levels of Th17 cells, greater CD8+ T cell proliferation and production of pro-inflammatory cytokines, molecular signatures associated with mucosal injury and repair likely mediated by innate immune cells, and a microbiota enriched for the Prevotellaceae family. These data provide a high-resolution model of the immunological, molecular, and microbiological perturbations induced by CRAI, will have direct utility in understanding rectal HIV transmission among MSM, and will enhance the design of future biomedical prevention interventions, including candidate HIV vaccines.

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Section: Discussionmentioning

confidence: 93%

The rectal mucosa and condomless receptive anal intercourse in HIV-negative MSM: implications for HIV transmission and prevention

et al. 2017

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“…11 In contrast to biomarkers for detection of semen in the vagina of cis women, [11][12][13][14][15][16][17][18][19][20][21] detection of prostate-specific antigen or Y chromosome (Yc) in the rectum is not a reliable biomarker for CRAI among MSM and TGW because both the receptive and insertive partners are positive for them. 22 Fortunately, forensic methodologies to distinguish polymorphisms in Y-chromosomal short tandem repeats (YSTRs) permit the separation of multiple Yc from the same sample. [23][24][25][26][27] Strand slippage during DNA replication makes different YSTR loci mutate frequently and independently from each other, depending on the number of repeats in noninterrupted repetitive stretches.…”

Section: Introductionmentioning

confidence: 99%

“…11 In contrast to biomarkers for detection of semen in the vagina of cis women, 11–21 detection of prostate-specific antigen or Y chromosome (Yc) in the rectum is not a reliable biomarker for CRAI among MSM and TGW because both the receptive and insertive partners are positive for them. 22…”

Section: Introductionmentioning

confidence: 99%

HIV-1 Nucleic Acids Identify Rectal HIV Exposures in Self-Collected Rectal Swabs, Whereas Y-Chromosome Single Tandem Repeat Mixtures Are Not Reliable Biomarkers of Condomless Receptive Anal Intercourse

Lemos

Nandi

Dragavon³

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: To focus interventions, biomarkers of HIV-1 exposure could help in identifying subpopulations at highest risk of acquisition. We assessed whether Y-chromosome single tandem repeat (YSTR) mixtures obtained from rectal swabs could serve as a biomarker of condomless receptive anal intercourse (CRAI) among men who have sex with men and transgender women and evaluated the feasibility of detecting HIV-1 virions to assess exposures.Methods: Twenty-nine sexually active HIV-seronegative men who have sex with men and one transgender woman from New York City answered on-site and mobile app sexual behavior questionnaires. They were randomized to collecting self-administered rectal swabs every morning or after receptive anal intercourse (RAI). YSTR profiles were assessed from blood sample and swabs; HIV-1 exposure was measured by conducting quantitative polymerase chain reaction in swabs.Results: After 2 months, the daily mobile survey had 135%-201% more instances of anal sex acts and 170%-193% more RAI than onsite surveys. Daily mobile reporting had 11%-35% less CRAI events than those reported on-site (P daily = 0.001; P per-sex = 0.047). The daily swabbing arm reported less RAI (P , 0.001) and CRAI (P , 0.038) and had 2.95 lower odds of detecting YSTR mixtures (P = 0.021) than the per-sex-event arm. Surprisingly, YSTR detection was not significantly modified by report of bowel movements and lubricant, enema, or condom use. No participant became HIV-1 infected, yet HIV-1 total nucleic acids were detected in 6 independent episodes of CRAI in 2 participants taking preexposure prophylaxis.Conclusions: YSTR mixtures demonstrated 80% specificity but only 30% sensitivity as a biomarker of CRAI in self-collected rectal swabs. However, detection of HIV-1 exposures in self-collected swabs may help in identifying those needing further HIV risk reduction strategies.

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Sullivan

Rosenberg

2015

Epidemiology

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Prostate-Specific Antigen is Unlikely to Be a Suitable Biomarker of Semen Exposure From Recent Unprotected Receptive Anal Intercourse in Men Who Have Sex With Men

Cited by 4 publications

References 17 publications

The rectal mucosa and condomless receptive anal intercourse in HIV-negative MSM: implications for HIV transmission and prevention

The rectal mucosa and condomless receptive anal intercourse in HIV-negative MSM: implications for HIV transmission and prevention

HIV-1 Nucleic Acids Identify Rectal HIV Exposures in Self-Collected Rectal Swabs, Whereas Y-Chromosome Single Tandem Repeat Mixtures Are Not Reliable Biomarkers of Condomless Receptive Anal Intercourse

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