Sexually Transmitted Infection Positivity Among Adolescents With or at High-Risk for Human Immunodeficiency Virus Infection in Los Angeles and New Orleans.

TitleSexually Transmitted Infection Positivity Among Adolescents With or at High-Risk for Human Immunodeficiency Virus Infection in Los Angeles and New Orleans.
Publication TypePublication
Year of Publication2019
AuthorsShannon CL, Keizur EM, Fehrenbacher A, Wood-Palmer D, Ramos W, Koussa M, Fournier J, Lee S-J, Patel D, Akabike WN, Abdalian SEllen, Rotheram-Borus MJane, Klausner JD
Corporate AuthorsAdolescent Trials Network(ATN) CARES Team
JournalSex Transm Dis
Date Published2019 Nov
KeywordsAdolescent, Antibodies, Bacterial, Bisexuality, Child, Chlamydia Infections, Female, Gonorrhea, HIV Infections, Homosexuality, Male, Humans, Ill-Housed Persons, Los Angeles, Male, New Orleans, Risk Factors, Sexual and Gender Minorities, Sexually Transmitted Diseases, Syphilis, Transgender Persons, Young Adult

<p><b>BACKGROUND: </b>Gay, bisexual, and transgender youth and homeless youth are at high risk for sexually transmitted infections (STIs). However, little recent data exist describing STI positivity by anatomical site among those groups. We determined the positivity of Chlamydia trachomatis (CT) infection, Neisseria gonorrhoeae (NG) infection, and syphilis antibody reactivity among lesbian, gay, bisexual, transgender, and homeless youth.</p><p><b>METHODS: </b>We recruited 1,264 adolescents with high risk behavior aged 12 to 24 years from homeless shelters, lesbian, gay, bisexual, and transgender organizations, community health centers, and using social media and online dating apps in Los Angeles, California and New Orleans, Louisiana from May 2017 to February 2019. Participants received point-of-care pharyngeal, rectal, and urethral/vaginal CT and NG testing and syphilis antibody testing. We calculated STI positivity by anatomical site and compared positivity by participant subgroups based on human immunodeficiency virus (HIV) status, sex assigned at birth, and gender identity.</p><p><b>RESULTS: </b>CT and NG positivity and syphilis antibody reactivity was higher among HIV-infected adolescent men who have sex with men (MSM) than HIV-uninfected adolescent MSM (40.2% vs. 19%, P < 0.05), particularly CT or NG rectal infection (28% vs. 12.3%, P < 0.05). Of participants with positive CT or NG infections, 65% had extragenital-only infections, 20% had both extragenital and urogenital infections, and 15% had urogenital-only infections.</p><p><b>CONCLUSIONS: </b>Sexually transmitted infection positivity was high, particularly among transgender women and MSM. The high proportion of rectal and pharyngeal infections highlights the importance of both urogenital and extragenital STI screening. More accessible STI testing is necessary for high-risk adolescent populations.</p>

Alternate JournalSex Transm Dis
PubMed ID31453926
PubMed Central IDPMC6812613
Grant ListUL1 TR000124 / TR / NCATS NIH HHS / United States
T32 MH109205 / MH / NIMH NIH HHS / United States
P30 AI028697 / AI / NIAID NIH HHS / United States
P30 MH058107 / MH / NIMH NIH HHS / United States
U19 HD089886 / HD / NICHD NIH HHS / United States
D43 TW009343 / TW / FIC NIH HHS / United States