Document Type
Article
Publication Date
2024
Publisher
Oxford University Press
Source Publication
Open Forum Infectious Diseases
Source ISSN
2328-8957
Original Item ID
DOI: 10.1093/ofid/ofae444
Abstract
Background
We estimated the predictive value of rectal (bacterial sexually transmitted infection [bSTI]) pathogen detection for future HIV seroconversion among young adult sexual and gender minorities (YSGMs) assigned male at birth (AMAB).
Methods
Data were collected between March 2018 and August 2022 from RADAR, a longitudinal cohort study of YSGMs AMAB living in the Chicago metropolitan area (n = 1022). Rates of rectal bSTIs and the proportion of self-reported rectal bSTI symptoms are reported. We examined whether the presence of rectal bSTIs predicted HIV seroconversion using generalized estimating equations (GEEs).
Results
Participants tested reactive for rectal Mycoplasma genitalium (MGen), Neisseria gonorrhoeae (NG), and Chlamydia trachomatis (CT) at a rate of 20.8 (95% CI, 18.4–23.5), 6.5 (95% CI, 5.0–8.2), and 8.4 (95% CI, 6.8–10.3) cases per 100 persons, respectively. There were no statistically significant pairwise differences in self-reported rectal bSTI symptoms between participants with self-collected swabs testing nonreactive vs reactive for rectal MGen (X2 = 0.04; P = .84), NG (X2 = 0.45; P = .37), or CT (X2 = 0.39; P = .46). In multivariate GEE analysis, rectal NG (adjusted odds ratio, 5.11; 95% CI, 1.20–21.77) was a statistically significant predictor of HIV seroconversion after controlling for other bSTIs, demographics, and sexual risk behavior.
Conclusions
Our findings provide a robust longitudinal estimation of the relationship between primarily asymptomatic rectal NG nucleic acid detection and HIV infection. These findings highlight the importance of asymptomatic screening for bSTIs and targeting biobehavioral intervention to prevent HIV infection among YSGMs with rectal bSTI agents detected.
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Baiers, Ross A.; Ryan, Daniel T.; Clifford, Antonia; Munson, Erik; D'Aquila, Richard; Newcomb, Michael E.; and Mustanski, Brian, "Asymptomatic Rectal Bacterial Pathogens Show Large Prospective Relationships With HIV Incidence in a Cohort of Young Sexual and Gender Minorities: Implications for STI Screening and HIV Prevention" (2024). Clinical Lab Sciences Faculty Research and Publications. 71.
https://epublications.marquette.edu/clinical_lab_fac/71
Comments
Published version. Open Forum Infectious Diseases, Vol. 11, No. 8 (2024). DOI. © 2024 The Authors Published by Oxford University Press on behalf of Infectious Diseases Society of America. Used with permission.