Trends in chlamydia and gonorrhea positivity among heterosexual men and men who have sex with men attending a large urban sexual health service in Australia, 2002-2009

Abstract

BackgroundTo determine whether chlamydia positivity among heterosexual men (MSW) and chlamydia and gonorrhea positivity among men who have sex with men (MSM), are changing.MethodsComputerized records for men attending a large sexual health clinic between 2002 and 2009 were analyzed. Chlamydia and gonorrhea positivity were calculated and logistic regression used to assess changes over time.Results17769 MSW and 8328 MSM tested for chlamydia and 7133 MSM tested for gonorrhea. In MSW, 7.37% (95% CI: 6.99-7.77) were chlamydia positive; the odds of chlamydia positivity increased by 4% per year (OR = 1.04; 95% CI: 1.01-1.07; p = 0.02) after main risk factors were adjusted for. In MSM, 3.70% (95% CI: 3.30-4.14) were urethral chlamydia positive and 5.36% (95% CI: 4.82-5.96) were anal chlamydia positive; positivity could not be shown to have changed over time. In MSM, 3.05% (95% CI: 2.63-3.53) tested anal gonorrhea positive and 1.83% (95% CI: 1.53-2.18) tested pharyngeal gonorrhea positive. Univariate analysis found the odds of anal gonorrhea positivity had decreased (OR = 0.93; 95% CI: 0.87-1.00; p = 0.05), but adjusting for main risk factors resulted in no change. Urethral gonorrhea cases in MSM as a percentage of all MSM tested for gonorrhea also fell (p < 0.001).ConclusionsThese data suggest that chlamydia prevalence in MSW is rising and chlamydia and gonorrhea prevalence among MSM is stable or declining. High STI testing rates among MSM in Australia may explain differences in STI trends between MSM and MSW.

Risk Factors of HIV Co-Infection and Sexual Behaviours in Patients with Gonococcal Infection in a STI′s Clinic in Madrid

“…The recent increase in new diagnoses of sexually transmitted HIV infections compared with the decrease in transmission by the use of injected drugs [26] along with the low frequency of condom use, highlights the persistence of high-risk sexual behaviours in the general Spanish population, as well as in other countries such as Australia [27][28][29]. Our study supports this observation in a particular subset of the Spanish population living in the capital of Spain.…”

Understanding trends in genitalChlamydia trachomatiscan benefit from enhanced surveillance: findings from Australia

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The near disappearance of genital warts in young women 4 years after commencing a national human papillomavirus (HPV) vaccination programme

“…We consider these possibilities to be unlikely for a number of reasons including the similarity between our earlier findings to the end of 20081 and the findings of the Australia-wide surveillance programme,2 the fact that our data have been adjusted for sexual behaviour which is the most important predictor of GW, the very large effect size that we have demonstrated and finally the absence of a decline in GW in unvaccinated groups in any risk group before July 2007. In addition, previous work has shown an increasing prevalence of other sexually transmitted infections among heterosexuals attending MSHC, which would make a fall in GW without vaccination even more unlikely10 11…”