High Prevalence of Chlamydia and Gonorrhea and the Need for Sexually Transmitted Infection Testing Among Men Who Have Sex With Men and Transgender Women in Papua New Guinea.
Journal
Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
pubmed:
26
9
2020
medline:
25
5
2021
entrez:
25
9
2020
Statut:
ppublish
Résumé
Papua New Guinea has among the highest prevalence of sexually transmitted infections in the world but no estimates of Chlamydia trachomatis, Neisseria gonorrhoeae, or hepatitis B virus (HBV) are available among men who have sex with men (MSM) or transgender women (TGW). We conducted respondent-driven sampling surveys among MSM and TGW in Port Moresby, Lae, and Mt Hagen (2016-2017) to characterize the prevalence of these infections. Eligibility criteria were as follows: aged ≥12 years, born male, could speak English or Tok Pisin, and had oral or anal sex with another person born male in the past 6 months. Participants were surveyed face-to-face and offered testing for anorectal and genital chlamydia and gonorrhea, syphilis, HIV, and HBV. All results are respondent-driven sampling weighted. We enrolled 400 participants in Port Moresby, 352 in Lae, and 111 in Mt Hagen. Chlamydia prevalence rates in the 3 cities regardless of anatomical site were 19.9%, 19.2%, and 24.3%, respectively. Gonorrhea prevalence rates regardless of anatomical site were 10.3%, 9.4%, and 9.6%, respectively. Hepatitis B virus prevalence rates were 11.7%, 13.8%, and 13.6%, respectively. In multivariable analysis, syphilis was associated with having either chlamydia or gonorrhea in Port Moresby (adjusted odds ratio, 4.0; 95% confidence interval, 2.0-7.9) and Lae (adjusted odds ratio, 2.4; 95% confidence interval, 1.2-5.0). There is a large unmet need among MSM and TGW in Papua New Guinea for chlamydia and gonorrhea detection and treatment. The high prevalence of HBV reinforces the importance of ensuring introduction and scale-up of HBV treatment and immunization. Urgent efforts are needed to introduce laboratory-based diagnosis for chlamydia and gonorrhea to ensure these populations have access to much needed treatment services.
Sections du résumé
BACKGROUND
Papua New Guinea has among the highest prevalence of sexually transmitted infections in the world but no estimates of Chlamydia trachomatis, Neisseria gonorrhoeae, or hepatitis B virus (HBV) are available among men who have sex with men (MSM) or transgender women (TGW).
METHODS
We conducted respondent-driven sampling surveys among MSM and TGW in Port Moresby, Lae, and Mt Hagen (2016-2017) to characterize the prevalence of these infections. Eligibility criteria were as follows: aged ≥12 years, born male, could speak English or Tok Pisin, and had oral or anal sex with another person born male in the past 6 months. Participants were surveyed face-to-face and offered testing for anorectal and genital chlamydia and gonorrhea, syphilis, HIV, and HBV. All results are respondent-driven sampling weighted.
RESULTS
We enrolled 400 participants in Port Moresby, 352 in Lae, and 111 in Mt Hagen. Chlamydia prevalence rates in the 3 cities regardless of anatomical site were 19.9%, 19.2%, and 24.3%, respectively. Gonorrhea prevalence rates regardless of anatomical site were 10.3%, 9.4%, and 9.6%, respectively. Hepatitis B virus prevalence rates were 11.7%, 13.8%, and 13.6%, respectively. In multivariable analysis, syphilis was associated with having either chlamydia or gonorrhea in Port Moresby (adjusted odds ratio, 4.0; 95% confidence interval, 2.0-7.9) and Lae (adjusted odds ratio, 2.4; 95% confidence interval, 1.2-5.0).
CONCLUSIONS
There is a large unmet need among MSM and TGW in Papua New Guinea for chlamydia and gonorrhea detection and treatment. The high prevalence of HBV reinforces the importance of ensuring introduction and scale-up of HBV treatment and immunization. Urgent efforts are needed to introduce laboratory-based diagnosis for chlamydia and gonorrhea to ensure these populations have access to much needed treatment services.
Identifiants
pubmed: 32976356
pii: 00007435-202102000-00006
doi: 10.1097/OLQ.0000000000001300
pmc: PMC8667082
mid: NIHMS1761910
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
109-117Subventions
Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Organisme : CGH CDC HHS
ID : U2G GH001531
Pays : United States
Informations de copyright
Copyright © 2020 American Sexually Transmitted Diseases Association. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest and Sources of Funding: None declared.
Références
Rowley J, Vander Hoorn S, Korenromp E, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: Global prevalence and incidence estimates, 2016. Bull World Health Organ 2019; 97:548–62P.
Fortenberry JD, McFarlane M, Bleakley A, et al. Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health 2002; 92:378–381.
Gottlieb SL, Stoner BP, Zaidi AA, et al. A prospective study of the psychosocial impact of a positive Chlamydia trachomatis laboratory test. Sex Transm Dis 2011; 38:1004–1011.
Korenromp EL, Sudaryo MK, de Vlas SJ, et al. What proportion of episodes of gonorrhoea and chlamydia becomes symptomatic?Int J STD AIDS 2002; 13:91–101.
Moss GB, Overbaugh J, Welch M, et al. Human immunodeficiency virus DNA in urethral secretions in men: Association with gonococcal urethritis and CD4 cell depletion. J Infect Dis 1995; 172:1469–1474.
Cohen MS, Hoffman IF, Royce RA, et al. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. AIDSCAP Malawi Research Group. Lancet 1997; 349:1868–1873.
Mayer KH, Venkatesh KK. Interactions of HIV, other sexually transmitted diseases, and genital tract inflammation facilitating local pathogen transmission and acquisition. Am J Reprod Immunol 2011; 65:308–316.
Beyrer C, Sullivan PS, Sanchez J, et al. A call to action for comprehensive HIV services for men who have sex with men. Lancet 2012; 380:424–438.
van Gemert C, Stoove M, Kwarteng T, et al. Chlamydia prevalence and associated behaviours among female sex workers in Vanuatu: Results from an integrated bio-behavioural survey, 2011. AIDS Behav 2014; 18:2040–2049.
Kelly A, Kupul M, Man WYN, et al. People Who Sell and/or Exchange Sex in Port Moresby. Key Quantitative Findings. Sydney, Australia: Papua New Guinea Institute of Medical Research and the University of New South Wales, 2011.
Hakim AJ, Coy K, Badman SG, et al. One size does not fit all: HIV prevalence and correlates of risk for men who have sex with men, transgender women in multiple cities in Papua New Guinea. BMC Public Health 2019; 19:623.
Kelly-Hanku A, Vallely A, Man WY, et al. A systematic review of heterosexual anal intercourse and its role in the transmission of HIV and other sexually transmitted infections in Papua New Guinea. BMC Public Health 2013; 13:1108.
Vallely A, Page A, Dias S, et al. The prevalence of sexually transmitted infections in Papua New Guinea: A systematic review and meta-analysis. PLoS One 2010; 5:e15586.
Kelly-Hanku AW, Weikum B, Boli Neo D, et al. Multi-Site Summary Report from the Key Population Integrated Bio-Behavioural Survey, Papua New Guinea. Goroka, Papua New Guinea: Papua New Guinea Institute of Medical Research and Kirby Institute, UNSW Sydney, 2018.
Heckathorn DD. Respondent-driven sampling: A new approach to the study of hidden populations. Soc Probl 1997; 44:174–199.
Heckathorn DD. Snowball versus respondent-driven sampling. Sociol Methodol 2011; 41:355–366.
Kelly-Hanku A, Bell S, Ase S, et al. Developing a culturally appropriate illustrated tool for the self-collection of anorectal specimens for the testing of sexually transmitted infections: Lessons from Papua New Guinea. BMC Public Health 2019; 19:214.
Health NDo. Standard Treatment Guidelines for Adults, 6th ed. Papua New Guinea, 2012.
WHO C, UNAIDS, FHI 360. Biobehavioral Survey Guidelines for Populations at Risk for HIV. Geneva: World Health Organization, 2017.
Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: Validity of a two-item depression screener. Med Care 2003; 41:1284–1292.
Gile KJ, Johnston LG, Salganik MJ. Diagnostics for respondent-driven sampling. J R Stat Soc Ser A Stat Soc 2015; 178:241–269.
Schweitzer A, Horn J, Mikolajczyk RT, et al. Estimations of worldwide prevalence of chronic hepatitis B virus infection: A systematic review of data published between 1965 and 2013. Lancet 2015; 386:1546–1555.
Unemo M, Bradshaw CS, Hocking JS, et al. Sexually transmitted infections: Challenges ahead. Lancet Infect Dis 2017; 17:e235–e279.
Wiesen E, Lagani W, Sui G, et al. Assessment of the hepatitis B birth dose vaccination program, Papua New Guinea, 2014. Vaccine 2016; 34:367–372.
Hakim AJ, Badman SG, Weikum D, et al. Considerable distance to reach 90-90-90 targets among female sex workers, men who have sex with men and transgender women in Port Moresby, Papua New Guinea: Findings from a cross-sectional respondent-driven sampling survey. Sex Transm Infect 2020; 96:143–150.
Otieno FO, Ndivo R, Oswago S, et al. Evaluation of syndromic management of sexually transmitted infections within the Kisumu Incidence Cohort Study. Int J STD AIDS 2014; 25:851–859.
Rietmeijer CA, Mungati M, Machiha A, et al. The etiology of male urethral discharge in Zimbabwe: Results from the Zimbabwe STI Etiology Study. Sex Transm Dis 2018; 45:56–60.
Mungati M, Machiha A, Mugurungi O, et al. The etiology of genital ulcer disease and coinfections with Chlamydia trachomatis and Neisseria gonorrhoeae in Zimbabwe: Results from the Zimbabwe STI Etiology Study. Sex Transm Dis 2018; 45:61–68.
Ferreira A, Young T, Mathews C, et al. Strategies for partner notification for sexually transmitted infections, including HIV. Cochrane Database Syst Rev 2013; 2013:Cd002843.
Kelly-Hanku AaB S. From HIV Self-Testing to Haus Dur Community-based HIV Testing. Review of Evidence From Low to Middle-Income Countries and Stakeholder Acceptability of New HIV Testing Models to Reach Key Populations in Papua New Guinea. Port Moresby, Papua New Guinea.: UNFPA and UNAIDS, 2019.
Kelly A, Kupul M, Nake Trumb R, et al. More than just a cut: A qualitative study of penile practices and their relationship to masculinity, sexuality and contagion and their implications for HIV prevention in Papua New Guinea. BMC Int Health Hum Rights 2012; 12:10.
Vallely AJ, MacLaren D, David M, et al. Dorsal longitudinal foreskin cut is associated with reduced risk of HIV, syphilis and genital herpes in men: A cross-sectional study in Papua New Guinea. J Int AIDS Soc 2017; 20:21358.
MacLaren DJ, McBride WJ, Kelly GC, et al. HIV prevalence is strongly associated with geographical variations in male circumcision and foreskin cutting in Papua New Guinea: An ecological study. Sex Transm Infect 2015; 91:502–505.