Recurrent sexually transmitted infections among a cohort of men who have sex with men using pre-exposure prophylaxis in Belgium are highly associated with sexualized drug use

T.M.I. Platteau, Irith De Baetselier, Thijs Reyniers, Kristien Wouters, Christiana Nöstlinger, Vicky Cuylaerts, Jozefien Buyze, Marie Laga, Chris R. Kenyon, Tania Crucitti, Bea Vuylsteke

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Men who have sex with men (MSM) experiencing recurrent STIs may play a crucial role in the STI epidemic. However, there is limited understanding of what kind of behaviour leads to recurrent STIs.

METHODS: A total of 179 MSM using PrEP were followed up for 18 months and were screened quarterly for chlamydia, gonorrhoea, and syphilis from 2015-2018 in Belgium. Participants were stratified into three different groups (no STI; one STI episode; recurrent STI episodes during the study). Socio-demographic and sexual behavioural characteristics were compared between the three groups and significant associations with recurrent STI were explored using multivariate logistic regression models.

RESULTS: A total of 62.0% (n=111/179) of participants experienced at least one STI during the study, and more than one in three became reinfected with an STI at another visit (n=66/179; 36.9%). Participants experiencing recurrent STIs reported the highest frequency of sexualized drug use (86.4%) compared to participants experiencing one (60.0%) or no STI (47.1%). Therefore, sexualized drug use was highly associated with recurrent STIs (adjusted odds ratio (aOR): 4.35). Other factors associated with recurrent STIs were being younger than 40 years old (aOR: 3.29), had a high number (>4) of non-steady partners with whom receptive (aOR: 1.17) or insertive (aOR:1.12) condomless anal intercourse occurred in the last three months CONCLUSIONS: Sexualised drug use was the greatest risk factor for having recurrent STIs. Tailoring prevention and care, including specialised services tackling problematic drug use in a sexual context, may help to curb the STI epidemic among MSM.
Original languageEnglish
Pages (from-to)726-732
Number of pages7
JournalSexually Transmitted Diseases
Volume48
Issue number10
DOIs
Publication statusPublished - Oct 2021

Keywords

  • CHLAMYDIA-TRACHOMATIS
  • NEISSERIA-GONORRHOEAE
  • PREP
  • RISK

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