Anorectal swabs as a marker of male-to-male sexual exposure in STI surveillance systems

F. H. AMPT, C. EL HAYEK, P. A. AGIUS, A. L. BOWRING, N. BARTNIK, C. VAN GEMERT, C. K. FAIRLEY, E. P. F. CHOW, C. S. BRADSHAW, N. STEPHENS, M. S.C. LIM, M. E. HELLARD

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Identification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007-2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45% were among reported MSM and an anorectal swab was performed in 40% of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87%, specificity = 99%, positive predictive value = 98·6%, negative predictive value = 90·3%). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.
Original languageEnglish
Pages (from-to)2530-2535
Number of pages6
JournalEpidemiology and Infection
Volume145
Issue number12
DOIs
Publication statusPublished - Sep 2017

Keywords

  • Chlamydia
  • men who have sex with men – MSM
  • sexually transmitted infections
  • surveillance

Cite this

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title = "Anorectal swabs as a marker of male-to-male sexual exposure in STI surveillance systems",
abstract = "Identification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007-2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45{\%} were among reported MSM and an anorectal swab was performed in 40{\%} of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87{\%}, specificity = 99{\%}, positive predictive value = 98·6{\%}, negative predictive value = 90·3{\%}). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.",
keywords = "Chlamydia, men who have sex with men – MSM, sexually transmitted infections, surveillance",
author = "AMPT, {F. H.} and {EL HAYEK}, C. and AGIUS, {P. A.} and BOWRING, {A. L.} and N. BARTNIK and {VAN GEMERT}, C. and FAIRLEY, {C. K.} and CHOW, {E. P. F.} and BRADSHAW, {C. S.} and N. STEPHENS and LIM, {M. S.C.} and HELLARD, {M. E.}",
year = "2017",
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language = "English",
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journal = "Epidemiology and Infection",
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Anorectal swabs as a marker of male-to-male sexual exposure in STI surveillance systems. / AMPT, F. H.; EL HAYEK, C.; AGIUS, P. A.; BOWRING, A. L.; BARTNIK, N.; VAN GEMERT, C.; FAIRLEY, C. K.; CHOW, E. P. F.; BRADSHAW, C. S.; STEPHENS, N.; LIM, M. S.C.; HELLARD, M. E.

In: Epidemiology and Infection, Vol. 145, No. 12, 09.2017, p. 2530-2535.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Anorectal swabs as a marker of male-to-male sexual exposure in STI surveillance systems

AU - AMPT, F. H.

AU - EL HAYEK, C.

AU - AGIUS, P. A.

AU - BOWRING, A. L.

AU - BARTNIK, N.

AU - VAN GEMERT, C.

AU - FAIRLEY, C. K.

AU - CHOW, E. P. F.

AU - BRADSHAW, C. S.

AU - STEPHENS, N.

AU - LIM, M. S.C.

AU - HELLARD, M. E.

PY - 2017/9

Y1 - 2017/9

N2 - Identification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007-2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45% were among reported MSM and an anorectal swab was performed in 40% of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87%, specificity = 99%, positive predictive value = 98·6%, negative predictive value = 90·3%). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.

AB - Identification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007-2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45% were among reported MSM and an anorectal swab was performed in 40% of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87%, specificity = 99%, positive predictive value = 98·6%, negative predictive value = 90·3%). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.

KW - Chlamydia

KW - men who have sex with men – MSM

KW - sexually transmitted infections

KW - surveillance

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U2 - 10.1017/S095026881700098X

DO - 10.1017/S095026881700098X

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JO - Epidemiology and Infection

JF - Epidemiology and Infection

SN - 0950-2688

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ER -