Prevalence, incidence and predictors of anal Chlamydia trachomatis, anal Neisseria gonorrhoeae and syphilis among older gay and bisexual men in the longitudinal Study for the Prevention of Anal Cancer (SPANC)

Sian Louise Goddard, Isobel M. Poynten, Kathy Petoumenous, Fengyi Jin, Richard J. Hillman, Carmella Law, Jennifer M. Roberts, Christopher K. Fairley, Suzanne M. Garland, Andrew E. Grulich, David J. Templeton, on behalf of the Study for the Prevention of Anal Cancer (SPANC) Research Team

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: Sexually transmitted infection (STI) notifications are increasing among older individuals. Many older gay and bisexual men (GBM) are sexually active and have multiple partners. We aimed to investigate the prevalence, incidence and predictors of anal chlamydia, anal gonorrhoea and syphilis in older GBM. Methods: The Study for the Prevention of Anal Cancer (SPANC) was a prospective cohort study of HPV infections and related anal lesions among community-recruited GBM age ≥ 35 years in Sydney, Australia. At baseline and subsequent annual visits, recent STI diagnoses were collected via questionnaire ('interval diagnoses') and STI testing occurred ('study visit diagnoses'). Baseline STI prevalence was calculated using study visit diagnoses. Incidence of anal chlamydia and gonorrhoea was calculated using interval and study visit diagnoses. Syphilis incidence was calculated using interval diagnoses. Univariate and multivariate analysis using Cox proportional hazards were undertaken to investigate the association between risk factors and incident STI. Results: Among 617 GBM, the median age was 49 years (range 35-79) and 35.8% (n=221) were HIV-positive. At baseline, STI prevalence was: anal chlamydia 2.3% (n=14); anal gonorrhoea 0.5% (n=3) and syphilis 1.0% (n=6). During 1428 person-years of follow-up (PYFU), the incidence (per 100 PYFU) of anal chlamydia, anal gonorrhoea and syphilis was 10.40 (95% CI 8.82 to 12.25), 9.11 (95% CI 7.64 to 10.85) and 5.47 (95% CI 4.38 to 6.84), respectively. In multivariate analysis, HIV-positivity, higher number of recent condomless receptive anal intercourse partners and baseline methamphetamine use were associated with each STI. Sex with 'fuck-buddies' was associated with anal chlamydia and gonorrhoea. Age was not associated with any STI. Discussion: There was a high incidence of STI among SPANC participants. Age should not be used as a proxy for sexual risk and older GBM require a detailed sexual behaviour and recreational drug use history. Interventions that specifically target STI risk among older GBM should be considered.

Original languageEnglish
Number of pages7
JournalSexually Transmitted Infections
DOIs
Publication statusAccepted/In press - 24 Apr 2019

Keywords

  • chlamydia trachomatis
  • gay men
  • neisseria gonorrhoea
  • sexual behaviour
  • syphilis

Cite this

Goddard, S. L., Poynten, I. M., Petoumenous, K., Jin, F., Hillman, R. J., Law, C., ... on behalf of the Study for the Prevention of Anal Cancer (SPANC) Research Team (Accepted/In press). Prevalence, incidence and predictors of anal Chlamydia trachomatis, anal Neisseria gonorrhoeae and syphilis among older gay and bisexual men in the longitudinal Study for the Prevention of Anal Cancer (SPANC). Sexually Transmitted Infections. https://doi.org/10.1136/sextrans-2019-054011
Goddard, Sian Louise ; Poynten, Isobel M. ; Petoumenous, Kathy ; Jin, Fengyi ; Hillman, Richard J. ; Law, Carmella ; Roberts, Jennifer M. ; Fairley, Christopher K. ; Garland, Suzanne M. ; Grulich, Andrew E. ; Templeton, David J. ; on behalf of the Study for the Prevention of Anal Cancer (SPANC) Research Team. / Prevalence, incidence and predictors of anal Chlamydia trachomatis, anal Neisseria gonorrhoeae and syphilis among older gay and bisexual men in the longitudinal Study for the Prevention of Anal Cancer (SPANC). In: Sexually Transmitted Infections. 2019.
@article{b6131b0bb1d94e70b3f5497e41907faa,
title = "Prevalence, incidence and predictors of anal Chlamydia trachomatis, anal Neisseria gonorrhoeae and syphilis among older gay and bisexual men in the longitudinal Study for the Prevention of Anal Cancer (SPANC)",
abstract = "Objectives: Sexually transmitted infection (STI) notifications are increasing among older individuals. Many older gay and bisexual men (GBM) are sexually active and have multiple partners. We aimed to investigate the prevalence, incidence and predictors of anal chlamydia, anal gonorrhoea and syphilis in older GBM. Methods: The Study for the Prevention of Anal Cancer (SPANC) was a prospective cohort study of HPV infections and related anal lesions among community-recruited GBM age ≥ 35 years in Sydney, Australia. At baseline and subsequent annual visits, recent STI diagnoses were collected via questionnaire ('interval diagnoses') and STI testing occurred ('study visit diagnoses'). Baseline STI prevalence was calculated using study visit diagnoses. Incidence of anal chlamydia and gonorrhoea was calculated using interval and study visit diagnoses. Syphilis incidence was calculated using interval diagnoses. Univariate and multivariate analysis using Cox proportional hazards were undertaken to investigate the association between risk factors and incident STI. Results: Among 617 GBM, the median age was 49 years (range 35-79) and 35.8{\%} (n=221) were HIV-positive. At baseline, STI prevalence was: anal chlamydia 2.3{\%} (n=14); anal gonorrhoea 0.5{\%} (n=3) and syphilis 1.0{\%} (n=6). During 1428 person-years of follow-up (PYFU), the incidence (per 100 PYFU) of anal chlamydia, anal gonorrhoea and syphilis was 10.40 (95{\%} CI 8.82 to 12.25), 9.11 (95{\%} CI 7.64 to 10.85) and 5.47 (95{\%} CI 4.38 to 6.84), respectively. In multivariate analysis, HIV-positivity, higher number of recent condomless receptive anal intercourse partners and baseline methamphetamine use were associated with each STI. Sex with 'fuck-buddies' was associated with anal chlamydia and gonorrhoea. Age was not associated with any STI. Discussion: There was a high incidence of STI among SPANC participants. Age should not be used as a proxy for sexual risk and older GBM require a detailed sexual behaviour and recreational drug use history. Interventions that specifically target STI risk among older GBM should be considered.",
keywords = "chlamydia trachomatis, gay men, neisseria gonorrhoea, sexual behaviour, syphilis",
author = "Goddard, {Sian Louise} and Poynten, {Isobel M.} and Kathy Petoumenous and Fengyi Jin and Hillman, {Richard J.} and Carmella Law and Roberts, {Jennifer M.} and Fairley, {Christopher K.} and Garland, {Suzanne M.} and Grulich, {Andrew E.} and Templeton, {David J.} and {on behalf of the Study for the Prevention of Anal Cancer (SPANC) Research Team}",
year = "2019",
month = "4",
day = "24",
doi = "10.1136/sextrans-2019-054011",
language = "English",
journal = "Sexually Transmitted Infections",
issn = "1368-4973",
publisher = "BMJ Group",

}

Goddard, SL, Poynten, IM, Petoumenous, K, Jin, F, Hillman, RJ, Law, C, Roberts, JM, Fairley, CK, Garland, SM, Grulich, AE, Templeton, DJ & on behalf of the Study for the Prevention of Anal Cancer (SPANC) Research Team 2019, 'Prevalence, incidence and predictors of anal Chlamydia trachomatis, anal Neisseria gonorrhoeae and syphilis among older gay and bisexual men in the longitudinal Study for the Prevention of Anal Cancer (SPANC)', Sexually Transmitted Infections. https://doi.org/10.1136/sextrans-2019-054011

Prevalence, incidence and predictors of anal Chlamydia trachomatis, anal Neisseria gonorrhoeae and syphilis among older gay and bisexual men in the longitudinal Study for the Prevention of Anal Cancer (SPANC). / Goddard, Sian Louise; Poynten, Isobel M.; Petoumenous, Kathy; Jin, Fengyi; Hillman, Richard J.; Law, Carmella; Roberts, Jennifer M.; Fairley, Christopher K.; Garland, Suzanne M.; Grulich, Andrew E.; Templeton, David J.; on behalf of the Study for the Prevention of Anal Cancer (SPANC) Research Team.

In: Sexually Transmitted Infections, 24.04.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prevalence, incidence and predictors of anal Chlamydia trachomatis, anal Neisseria gonorrhoeae and syphilis among older gay and bisexual men in the longitudinal Study for the Prevention of Anal Cancer (SPANC)

AU - Goddard, Sian Louise

AU - Poynten, Isobel M.

AU - Petoumenous, Kathy

AU - Jin, Fengyi

AU - Hillman, Richard J.

AU - Law, Carmella

AU - Roberts, Jennifer M.

AU - Fairley, Christopher K.

AU - Garland, Suzanne M.

AU - Grulich, Andrew E.

AU - Templeton, David J.

AU - on behalf of the Study for the Prevention of Anal Cancer (SPANC) Research Team

PY - 2019/4/24

Y1 - 2019/4/24

N2 - Objectives: Sexually transmitted infection (STI) notifications are increasing among older individuals. Many older gay and bisexual men (GBM) are sexually active and have multiple partners. We aimed to investigate the prevalence, incidence and predictors of anal chlamydia, anal gonorrhoea and syphilis in older GBM. Methods: The Study for the Prevention of Anal Cancer (SPANC) was a prospective cohort study of HPV infections and related anal lesions among community-recruited GBM age ≥ 35 years in Sydney, Australia. At baseline and subsequent annual visits, recent STI diagnoses were collected via questionnaire ('interval diagnoses') and STI testing occurred ('study visit diagnoses'). Baseline STI prevalence was calculated using study visit diagnoses. Incidence of anal chlamydia and gonorrhoea was calculated using interval and study visit diagnoses. Syphilis incidence was calculated using interval diagnoses. Univariate and multivariate analysis using Cox proportional hazards were undertaken to investigate the association between risk factors and incident STI. Results: Among 617 GBM, the median age was 49 years (range 35-79) and 35.8% (n=221) were HIV-positive. At baseline, STI prevalence was: anal chlamydia 2.3% (n=14); anal gonorrhoea 0.5% (n=3) and syphilis 1.0% (n=6). During 1428 person-years of follow-up (PYFU), the incidence (per 100 PYFU) of anal chlamydia, anal gonorrhoea and syphilis was 10.40 (95% CI 8.82 to 12.25), 9.11 (95% CI 7.64 to 10.85) and 5.47 (95% CI 4.38 to 6.84), respectively. In multivariate analysis, HIV-positivity, higher number of recent condomless receptive anal intercourse partners and baseline methamphetamine use were associated with each STI. Sex with 'fuck-buddies' was associated with anal chlamydia and gonorrhoea. Age was not associated with any STI. Discussion: There was a high incidence of STI among SPANC participants. Age should not be used as a proxy for sexual risk and older GBM require a detailed sexual behaviour and recreational drug use history. Interventions that specifically target STI risk among older GBM should be considered.

AB - Objectives: Sexually transmitted infection (STI) notifications are increasing among older individuals. Many older gay and bisexual men (GBM) are sexually active and have multiple partners. We aimed to investigate the prevalence, incidence and predictors of anal chlamydia, anal gonorrhoea and syphilis in older GBM. Methods: The Study for the Prevention of Anal Cancer (SPANC) was a prospective cohort study of HPV infections and related anal lesions among community-recruited GBM age ≥ 35 years in Sydney, Australia. At baseline and subsequent annual visits, recent STI diagnoses were collected via questionnaire ('interval diagnoses') and STI testing occurred ('study visit diagnoses'). Baseline STI prevalence was calculated using study visit diagnoses. Incidence of anal chlamydia and gonorrhoea was calculated using interval and study visit diagnoses. Syphilis incidence was calculated using interval diagnoses. Univariate and multivariate analysis using Cox proportional hazards were undertaken to investigate the association between risk factors and incident STI. Results: Among 617 GBM, the median age was 49 years (range 35-79) and 35.8% (n=221) were HIV-positive. At baseline, STI prevalence was: anal chlamydia 2.3% (n=14); anal gonorrhoea 0.5% (n=3) and syphilis 1.0% (n=6). During 1428 person-years of follow-up (PYFU), the incidence (per 100 PYFU) of anal chlamydia, anal gonorrhoea and syphilis was 10.40 (95% CI 8.82 to 12.25), 9.11 (95% CI 7.64 to 10.85) and 5.47 (95% CI 4.38 to 6.84), respectively. In multivariate analysis, HIV-positivity, higher number of recent condomless receptive anal intercourse partners and baseline methamphetamine use were associated with each STI. Sex with 'fuck-buddies' was associated with anal chlamydia and gonorrhoea. Age was not associated with any STI. Discussion: There was a high incidence of STI among SPANC participants. Age should not be used as a proxy for sexual risk and older GBM require a detailed sexual behaviour and recreational drug use history. Interventions that specifically target STI risk among older GBM should be considered.

KW - chlamydia trachomatis

KW - gay men

KW - neisseria gonorrhoea

KW - sexual behaviour

KW - syphilis

UR - http://www.scopus.com/inward/record.url?scp=85065294193&partnerID=8YFLogxK

U2 - 10.1136/sextrans-2019-054011

DO - 10.1136/sextrans-2019-054011

M3 - Article

JO - Sexually Transmitted Infections

JF - Sexually Transmitted Infections

SN - 1368-4973

ER -