P3.127 High Prevalence of Asymptomatic Sexually Transmitted Infections (STIs) in HIV-Infected Men Who Have Sex with Men (MSM) in Ireland: Strategies to Improve Screening

Abstract

BackgroundIn Ireland the prevalence of STI's is steadily increasing while the number of new HIV-diagnoses in MSM has more than doubled in the past decade. International guidelines recommend annual STI screening for MSMs regardless of reported history, with more frequent screening recommended for at-risk individuals. This study investigates prevalence of STIs in asymptomatic HIV-infected MSM in the largest HIV-centre in Dublin.MethodsA retrospective analysis was performed via electronic patient record review. Pharyngeal, urethral and rectal testing for Gonorrhoea (Gc) and Chlamydia (CT) was performed using validated nucleic acid amplification techniques.ResultsFifty HIV-infected MSM were included in the study (mean age [SD] 38 years [9], 66% Irish). Mean [SD] number of sexual partners in the preceding 12 months was 8 [13]. By subject report 10% were abstinent, 40% always used condoms, 42% used codoms inconsistently while 4% reported never using condoms. Thirty-nine (78%) were on HAART and 38 (97%) were virally suppressed.Eight (16%) tested positive for an STI. Two (25%) were documented as having two concurrent STIs and two (25%) were not on HAART.Gc was detected in all 8 positive screens (4 cases of rectal and 4 cases of pharyngeal Gc). There were 2 cases of rectal CT which occurred with a concurrent positive rectal Gc. Younger age [29 vs. 40 years, p < 0.001] was the only independent predictor of positive STI screen.ConclusionSixteen percent of HIV-infected MSMs screened were diagnosed with an STI. 46% of HIV-infected MSM reported unprotected sexual activity. Recognising a need to optimise provision and delivery of STI screening, a pilot self-screening programme has been successfully introduced to our HIV-clinic. Our study highlights the importance of screening for asymptomatic STI's and the need for increased educational interventions targeting unsafe sexual-behaviour as a means of disease prevention.