Foretelling the Future: Predicting STI Diagnosis and Its Implications for Ending the HIV Epidemic among Black Men Who Ha
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Foretelling the Future: Predicting STI Diagnosis and Its Implications for Ending the HIV Epidemic among Black Men Who Have Sex with Men Paul A. Burns & Leandro A. Mena & Richard L. Crosby
# The New York Academy of Medicine 2020
Abstract Despite evidence of the link between STI and HIV transmission, STI rates remain alarmingly high, particularly among racial/ethnic minorities. This study examined the relationship between earlier STI diagnoses (gonorrhea and chlamydia) and future STI acquisition and its implications for HIV prevention among a sample of urban Black men who have sex with men (Black MSM). Data from a cohort of 600 Black MSM (15– 29 years of age) residing in a medium-size Southern city enrolled in a HIV prevention intervention were analyzed. We used multivariate logistic regression to assess the association between STI diagnosis (baseline: Time 1) and subsequent STI diagnosis (90-day post-diagnosis: Time 2). Repeated measures analyzed at Time 1 and Time 2 included condomless sex, insertive and receptive Short Summary A longitudinal study of Black MSM diagnosed with gonorrhea and chlamydia at baseline found clients were 15 times more likely to have a subsequent diagnosis 90-day postinitial diagnosis compared to those who were not diagnosed with STI. There is an urgent need to expand HIV prevention efforts to include routine STI screening, particularly screening for extragenital STI and to develop new HIV prevention programs that promote condom use and safer sex practices alongside PrEP for at-risk Black MSM. P. A. Burns (*) : L. A. Mena Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA e-mail: [email protected] R. L. Crosby College of Public Health, University of Kentucky, Lexington, KY, USA
sex, concurrent sexual partnerships, multiple partners, and age of partner. Independent of socio-demographic factors, we found having a prior GC/CT increased the likelihood of a future GC/CT by a factor of 15 (OR = 15.2, p = 0.01). Participants were statistically more likely to have been diagnosed with an extragenital STI (OR = 2.3, p = 0.05). Present findings suggest that time of initial STI diagnosis is a critical period in which to intervene to reduce future STI/HIV acquisition. Screening guidelines should be expanded to include testing for extragenital infection. STI screening and treatment and counseling programs should be culturally appropriate to account for the unique needs and the social and environmental context of the population. Additional research is needed to design STI prevention interventions that address social and environmental factors to reduce sexual risk behaviors that increase HIV vulnerability for Black MSM. Keywords Sexually transmitted infections . Sexually transmitted diseases . Extragenital . Acquired immunodeficiency syndrome . AIDS . Human immunodeficiency virus . HIV . HIV/AIDS . Gonorrhea . Chlamydia . Men who have sex with men . MSM . Black MSM
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