High prevalence of anal chlamydia in Swiss HIV-positive gay men

via Aidsmap, by Michael Carter

A large proportion of HIV-positive gay men in Switzerland have anorectal infection with chlamydia, investigators report in the November 15th edition of Clinical Infectious Diseases. The researchers suggest that undiagnosed anal chlamydia infections could be contributing to the continued spread of HIV amongst gay men in Switzerland.

Gay and other men who have sex with men remain the group most affected by HIV in many industrialised countries, including Switzerland. Sexually transmitted infections also disproportionately affect gay men. If left untreated these infections, including chlamydia, can significantly increase the risk of acquiring HIV. As reported on aidsmap.com UK investigators found that many chlamydia infections in gay men were in the rectum, and that HIV-positive gay men were disproportionately affected by rectal chlamydia

Investigators from the Swiss HIV cohort therefore postulated that anorectal chlaymdia infection could be contributing to the ongoing HIV epidemic amongst gay men in the country.

They therefore screened 147 HIV-positive men who reported unprotected receptive anal sex in the previous two years for the infection. The aims of their study were to determine the prevalence and symptoms of anorectal chlamydia, and to see if they could identify any risk factors associated with the infection.

Read the rest.

The CDC Says, "Swab that Booty!"

The CDC recommends screening of at-risk men who have sex with men (MSM) at least annually for urethral and rectal gonorrhea and chlamydia, and for pharyngeal gonorrhea. Although the standard method for diagnosis is culture, nucleic acid amplification (NAA) testing is generally more sensitive and favored by most experts. NAA tests have not been cleared by the Food and Drug Administration (FDA) for the diagnosis of extragenital chlamydia or gonorrhea and may not be marketed for that purpose. However, under U.S. law, laboratories may offer NAA testing for diagnosis of extragenital chlamydia or gonorrhea after internal validation of the method by a verification study.

To determine sexually transmitted disease (STD) testing practices among community-based organizations serving MSM, CDC and the San Francisco Department of Public Health gathered data on rectal and pharyngeal gonorrhea and chlamydia testing at screening sites managed by six gay-focused community-based organizations in five U.S. cities during 2007. This report summarizes the results of the study, which found that three organizations collected samples for NAA testing and three for culture. In total, approximately 30,000 tests were performed; 5.4% of rectal gonorrhea, 8.9% of rectal chlamydia, 5.3% of pharyngeal gonorrhea, and 1.6% of pharyngeal chlamydia tests were positive.

These results demonstrate that gay-focused community-based organizations can detect large numbers of gonorrhea and chlamydia cases and might reach MSM not being tested elsewhere. Public health officials could consider providing support to certain community-based organizations to facilitate testing and treatment of gonorrhea and chlamydia.

Read the rest at the CDC.

Alternatives to condom use can help reduce HIV transmission among gay men

via Fridae - empowering gay Asia - by Jan Wijngaarden

The HIV epidemic among gay men in Asia is continuing to grow. 30.7 percent of Thai men who have sex with men are now infected with HIV in Bangkok; in Cambodia, Vietnam and Indonesia between 5-10 percent of men who have sex with men have HIV. In a cross-sectional study among MSM in Taipei in 2004, the HIV prevalence was 8.5 percent; in Singapore in 2007, 4.2 percent; and in Hong Kong in 2006-7, 4.1 percent. In most places our transgender sisters are even harder hit.

And that while transmission of HIV is quite hard, with a relatively low per-contact-transmission chance – HIV is much less efficient than other viruses, such as the ones causing flu or measles. Preventing HIV is relatively simple – covering our favorite organ with a 0.06 mm thick coating whenever we have anal sex...

Yes indeed, I am talking about condoms. So why are – even in places were significant numbers of men are infected with HIV – significant numbers of men still not using condoms? Are they not thinking clearly or what?

Well – perhaps so. A recent study from Sydney, Australia that appeared in the AIDS journal earlier this year (Jin F, Crawford J, Prestage GP et al, 2009) found that even when men do not use condoms, they still employ certain strategies to reduce their risk for HIV infection (or for transmitting HIV to their partners, if they are already HIV positive). Three of these strategies were found to reduce the chance of getting HIV significantly, compared to men who did not use any strategy (and no condoms).

These strategies are not as effective and not as safe as always using condoms, but nevertheless, they are protective.

What were these strategies?

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Gay men should have rectal tests for chlamydia as part of routine sexual health care

via Aidsmap

Gay men should have rectal tests for chlamydia as part of their routine sexual health care, investigators recommend in an article published in the online edition of Sexually Transmitted Infections. Researchers found that more gay men had rectal infection with chlamydia than had urethral chlamydia or rectal gonorrhoea. Furthermore, the majority of rectal chlamydia infections were asymptomatic and would therefore have been missed without routine testing.

They also found that over a third of the men with rectal chlamydia were HIV-positive.

Read the rest.

What is chlamydia anyway?