The prevalence of urethral and rectal Mycoplasma genitalium and its associations in men who have sex with men attending a genitourinary medicine clinic

Abstract

Rates of MG are much higher in HIV-positive MSM than HIV-negative MSM at both urethral and rectal sites, and MG is more prevalent in HIV-positive MSM than other bacterial STI. Although the subclinical nature of MG in the rectum questions its significance, the high prevalence seen at this site could be a potential source of onward urethral transmission. Future work should assess the need for appropriate screening and treatment of MG infection in MSM, particularly those with HIV infection and high-risk sexual behaviour.

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

“…The overall prevalence of anogenital M. genitalium was substantially lower than chlamydia or gonorrhoea, a pattern consistent with the prevalence of rectal infections among MSM clinic attendees in the US. 69 This contrasts with findings from a UK clinic-based study, 70 where the overall prevalence of all three infections was similar (5-8%), but among a subgroup of HIV-positive men, the prevalence of M. genitalium was substantially higher (21%) than that of either gonorrhoea (8%) or chlamydia (13%).…”

“…68 Although anorectal M. genitalium was identified in under 2% of Australian SOPV attendees, 68 a higher anorectal M. genitalium prevalence (4-6%) has been reported among sexual health clinic attendees overseas. 70,76 Urethral-to-anal transmission has been reported in MSM, 77 although no significant association of M. genitalium with anorectal symptoms or clinical proctitis has been described. 68,70,76 Multiple studies report an association between M. genitalium and HIV infection.…”

“…70,76 Urethral-to-anal transmission has been reported in MSM, 77 although no significant association of M. genitalium with anorectal symptoms or clinical proctitis has been described. 68,70,76 Multiple studies report an association between M. genitalium and HIV infection. M. genitalium prevalence appears to be significantly higher at both anal and genital sites among HIVpositive MSM compared with HIV-negative MSM in UK and US clinical settings.…”

“…69 Findings from clinic-based studies suggest that M. genitalium is detected significantly more often in men with NGU than in asymptomatic patients. [70][71][72][73] Nonetheless, M. genitalium-related NGU appears to be significantly less common among MSM compared with heterosexual men. 72,74 Evidence for a role of M. genitalium in ascending male genital infections is lacking 75 and there is currently no evidence that M. genitalium colonises or infects the pharynx of MSM.…”

“…M. genitalium prevalence appears to be significantly higher at both anal and genital sites among HIVpositive MSM compared with HIV-negative MSM in UK and US clinical settings. 70,76 A 2009 systematic review and metaanalysis 78 reported a statistically significant association of M. genitalium and HIV in 12 of 19 included studies, although only two included MSM. Most importantly, very few included studies were of prospective design and the critical question of temporal relationship remains unanswered.…”