Examining the prevalence of extragenital STI testing in the past 12 months by demographic, clinical, and behavioral factors among young, black men who have sex with men—Atlanta, GA Open Access

Shi, Mengyuan (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/m039k595p?locale=pt-BR%2A
Published

Abstract

Background: STI screening, i.e., testing for STIs in the absence of any clinical signs or symptoms, is an important public health intervention to decrease STI transmission. Current CDC guidelines recommend MSM be screened for STIs such as syphilis, gonorrhea, chlamydia at least annually. There is remarkable heterogeneity in STI prevalence among MSM, particularly young, black MSM (YBMSM), according to geography, race, and HIV status. In this study, we determined the prevalence of any STI testing in the past 12 months, and to compare the prevalence of urogenital STI screening to any extragenital STI screening and associated factors in Atlanta.

Methods: Study participants were enrolled in the EleMENt study, a prospective, observational cohort study that enrolled YBMSM in Atlanta, Georgia (GA) from 2015 to 2019. In total, there were 464 participants in our cross-sectional sample. We calculated the prevalence of participants having had a STI testing (other than HIV), a urogenital STI test and an extragenital STI test in the past 12 months and described the association of prevalence with demographic and behavioral characteristics. We used multivariate log-binomial regression models to calculate prevalence ratios (PRs) and corresponding 95% confidence intervals.

Results: Among the 300 participants who tested for STI in the past 12 months, 274 (60.8%), 193 (42.8%), and 259 (57.4%) had a urogenital, extragenital, and serology-based syphilis test, respectively. The prevalence of getting STI testing among participants with less than high school education, were half of that among participants attending up to college, post graduate, professional school (crude prevalence ratio (cPR = 0.5). YBMSM with no healthcare access had half the prevalence of urogenital or extragenital testing compared to YBMSM with some form of healthcare access (cPR = 0.5). MSM having STIs symptoms had 20% higher probability of getting extragenital testing compared to asymptomatic YBMSM (cPR = 1.2).

Conclusion: In this large cohort of YBMSM, about two-thirds reported STI testing in the past 12 months. More efforts are needed to increase prevalence of STI testing among YBMSM, especially among men with lower educational attainment, men without healthcare coverage, and asymptomatic men.

Table of Contents

Introduction. 1

Sexually Transmitted Infections in the United States. 1

STI screening and testing. 2

STIs/HIV among MSM.. 3

Methods 6

Study population and study design. 6

Demographics, STI symptoms and sexual risk variables 7

STI Testing. 8

Statistical Analysis. 9

Study Population. 12

Demographic, Clinical, and Behavioral Characteristics at Baseline. 12

Stratified by Any STI Testing in the Past 12 months (other than HIV testing) 13

Demographic, clinical, and behavioral characteristics stratified by urogenital & extragenital STI testing 14

STI testing stratified by urogenital & extragenital testing among baseline HIV-negative participants. 15

Geographical distribution. 15

Discussion. 17

Conclusion. 20

Acknowledgement 20

Funding. 20

Figure. 21

Figure 1a. Flow diagram of young black men who have sex with men and their self-reported STI testing patterns, EleMENt cohort, Atlanta, GA, 2015-2019. 21

Figure 1b. Flow diagram of young black men who have sex with men and their self-reported STI testing patterns, EleMENt cohort, Atlanta, GA, 2015-2019. 22

Figure 2. Venne diagram illustrating the number of participants getting urogenital, extragenital and blood test, in young black men who have sex with men, EleMENt cohort, Atlanta, GA, 2015-2019. 23

Figure 3. Spatial distribution of the sources of EleMENt participants, in young black men who have sex with men, Atlanta, GA, 2015-2019 24

Figure 4a. Spatial distribution of EleMENt participants who did not have STI testing (regardless of HIV testing) in the past 12 months, in young black men who have sex with men, Atlanta, GA, 2015-2019. 25

Figure 4b. Spatial distribution of EleMENt participants who had STI testing (regardless of HIV testing) in the past 12 months, in young black men who have sex with men, Atlanta, GA, 2015-2019. 26

Table. 27

Table 1. Demographic, clinical and behavioral characteristics of EleMENt participants at baseline, in young black men who have sex with men, Atlanta, GA, 2015-2019. 27

Table 2. Demographic, clinical and behavioral characteristics of EleMENt participants stratified by urogenital and extragenital testing, in young black men who have sex with men, Atlanta, GA, 2015-2019. 28

Table 3. Demographic, clinical and behavioral characteristics of HIV-negative EleMENt participants stratified by urogenital and extragenital testing, in young black men who have sex with men, Atlanta, GA, 2015-2019. 30

Appendix. 32

Selected Questions from EleMENt Questionnaire. 32

References 38

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Examining the prevalence of extragenital STI testing in the past 12 months by demographic, clinical, and behavioral factors among young, black men who have sex with men—Atlanta, GA () 2020-04-28 18:52:12 -0400

Supplemental Files

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Demographic, clinical and behavioral characteristics of EleMENt participants at baseline, in young black men who have sex with men, Atlanta, GA, 2015-2019 (Table1) 2020-04-28 18:52:15 -0400
Demographic, clinical and behavioral characteristics of EleMENt participants stratified by urogenital and extragenital testing, in young black men who have sex with men, Atlanta, GA, 2015-2019 (Table2) 2020-04-28 18:52:20 -0400
Demographic, clinical and behavioral characteristics of HIV-negative EleMENt participants stratified by urogenital and extragenital testing, in young black men who have sex with men, Atlanta, GA, 2015-2019 (Table3) 2020-04-28 18:52:24 -0400