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Prevalence of Bacterial Sexually Transmitted Infections and Pre-Exposure Prophylaxis Eligibility in a Cross-Sectional Sample of HIV Negative Men who have Sex with Men in Atlanta Georgia

Foster, Loretta Lynn (2015)
Master's Thesis (44 pages)
Committee Chair / Thesis Adviser: Rosenberg, Eli S
Committee Members:
Research Fields: Health Sciences, Public Health; Health Sciences, Epidemiology
Partnering Agencies: Emory University schools, faculty or affiliated programs
Keywords: MSM; STI; PrEP; Atlanta
Program: Rollins School of Public Health, Epidemiology (Epidemiology)
Permanent url: http://pid.emory.edu/ark:/25593/pkxxc

Abstract

Objectives: To determine any predictors of bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) in Atlanta GA and to determine if CDC PrEP eligibility correlates to positive STI diagnosis.

Methods: A subgroup of HIV negative non-Hispanic white and black MSM was gathered from the InvolveMENt and The MAN Project studies. Participants completed a computer based questionnaire with questions about demographic, psychosocial, individual level sexual risk behaviors, and dyadic information. Men were also screened for chlamydia, gonorrhea, and syphilis.

Results: 265 participants were selected for analysis. Racial composition was 57.0% black and 43.0% white. 33 (12.5%) participants were diagnosed with at least one STI. Prevalence of chlamydia was 8.7%, gonorrhea 6.0%, and syphilis 1.5%. Multiple infection prevalence was 3.8% with 90% of co-infections chlamydia and gonorrhea, and 10% chlamydia and syphilis. Rectal infections were more common than urethral infections Predictors of a positive STI diagnosis were black race, lower education, and lack of health insurance. CDC PrEP eligibility guidelines were not associated with STI diagnosis.

Conclusion: Atlanta MSM exhibit high prevalence of bacterial STIs with respect to racial and educational divisions. CDC PrEP eligibility guidelines do not fit this population and should be altered to better predict individuals who are engaging in high risk behaviors and acquiring bacterial STIs.

Table of Contents

Table of Contents
Background 1
Methods 6
Results 11
Discussion 15
Tables 21
Table 1. Characteristics of a Cross-Sectional Sample of HIV Negative MSM from InvolveMENt and MAN Project Participants 21
Table 2. Bivariate Analysis of Characteristics of a Cross-Sectional Sample of HIV Negative MSM from InvolveMENt and MAN Project Participants At least 1 Prevalent STI Compared to No STI 25
Table 3. Characteristics of Prevalent STI in a Cross-Sectional Sample of HIV Negative MSM from InvolveMENt and MAN Project Participants 28
Table 4. PrEP Eligibility of a Cross-Sectional Sample of HIV Negative MSM from InvolveMENt and MAN Project Participants 31
Appendices 32
A. CDC Guidelines for High Risk Individuals suited to PrEP 32
B. PrEP Eligibility Scoring Algorithm based on CDC Guidelines Box A1. 32
References 34

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