High prevalence of extra-genital chlamydial or gonococcal infections among men who have sex with men and transgender women in Lima, Peru

Abstract

Chlamydia trachomatis and Neisseria gonorrhoeae are among the most common sexually transmitted bacterial infections in the world. Data are limited, however, on the burden of extra-genital chlamydial and gonococcal infections among men who have sex with men and transgender women in Lima, Peru. Data were gathered from self-collected anal or pharyngeal swabs from participants in Lima, Peru, and analyzed via cross-sectional methods. Prevalence ratios for the association between extra-genital infection with socio-demographic and sexual behaviors were determined. Overall, 127 (32.8%) participants had anal or pharyngeal infections. On multivariate modeling, anal infection was positively associated with practicing both receptive and insertive anal sex, when compared to insertive alone (PR = 2.49; 95% CI = 1.32-4.71), and negatively associated with any antibiotic use in the prior three months (PR = 0.60; 95% CI = 0.39-0.91). Pharyngeal infection was negatively associated with age greater than 30 years compared to 18-30 years (PR = 0.54; 95% CI = 0.30-0.96), and positively associated with gender identity of transgender women (PR = 2.12; 95% CI = 1.20-3.73). This study demonstrates considerable burden of extra-genital chlamydial and gonococcal infections among men who have sex with men and transgender women in Lima, Peru.

Keywords: Chlamydia (Chlamydia trachomatis); Peru; Pharyngeal; Rectal; South America; epidemiology; gonorrhea (Neisseria gonorrhoeae); homosexual.

Figure 1

Percent of men who have sex with men or transgender women infected with either anal or pharyngeal Neisseria gonorrhoeae or Chlamydia trachomatis from a clinic-based cohort in Lima, Peru between May 2013 and May 2014. MSM: men who have sex with men. Anal infection with N. gonorrhoeae or C. trachomatis was positively associated with practicing both receptive and insertive anal sex, when compared to insertive only (adjusted PR = 2.49; 95% CI = 1.32–4.71), and negatively associated with antibiotic use in the prior three months compared to those with no reported antibiotic use (adjusted PR = 0.60; 95% CI = 0.39–0.91). Pharyngeal infection with N. gonorrhoeae or C. trachomatis was negatively associated with age older than 30 years when compared to age between 18 and 30 years (adjusted PR = 0.54; 95% CI = 0.30–0.96), and positively associated with gender identity of transgender women (adjusted PR = 2.12; 95% CI = 1.20–3.73) (Table).