Almost half of the MSM taking HIV-PrEP tested positive for gastrointestinal pathogens

August 15, 2021

Read for 2 minutes

Source / information

Published by:

Disclosure:
The authors do not report any relevant financial information.

ADD SUBJECT TO EMAIL ALERTS

Receive an email when new articles are published on

Please enter your email address to receive an email when new articles are published on . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If this problem persists, please contact [email protected].

Back to Healio

In a small study, researchers found gastrointestinal pathogens in 45% of men who had sex with men who were taking HIV-PrEP, according to results posted on the Open Forum Infectious Diseases.

“Sexual transmission of gastrointestinal (GI) pathogens is both a historic and an emerging phenomenon in men who have sex with men (MSM), with Shigella and Campylobacter outbreaks becoming more common worldwide.” Lawrence Purpura, MD, MPH & TM, an Infectious Disease Fellow at Columbia University’s Irving Medical Center, and colleagues wrote.

50 purple, et al. Open Forum Infect Dis. 2021. doi: 10.1093 / Ofidi / ofab411.

“Outside of outbreak studies, the prevalence of gut pathogens in MSM is not well characterized,” they wrote. “So far there is a lack of prospective data on prevalence and symptoms.”

Purpura and colleagues examined the prevalence of GI pathogens and the correlation with clinical factors in HIV-negative MSM who received a PrEP between February 7, 2019 and March 12, 2020 at a sex clinic in New York, in addition to flocculated rectal smear at the same time as a rectal smear for gonorrhea and chlamydia tests at regular 3-month clinic visits for PrEP follow-up care and tested them on 22 organisms.

Between February 7, 2019 and March 12, 2020, 110 of 148 participants in a PrEP adherence study called Stick2PrEP in the sub-study took GI pathogens, with a total of 194 rectal swabs taken.

According to the study, at least one organism was detected in 62 (32%) rectal swabs from 50 (45%) participants. Tests detected enteropathogenic Escherichia coli in 20 (10%) smears, Giardia lamblia in 19 (10%), enteroaggregative E. coli in 16 (8%), Campylobacter in 14 (7%), Shigella / enteroinvasive E. coli in four ( 2%), enterotoxigenic E. coli in one, Vibrio in two, Cryptosporidium in two, norovirus in two and sapovirus in one.

Pathogens were detected in multiple swabs in some study participants, including two subjects who had Giardia detected on three consecutive swabs, one who had Campylobacter detected on three consecutive swabs, and another patient who had enteropathogenic E. coli three consecutive smears were detected, Purpura and colleagues reported.

The study also showed that the frequency of symptoms was high regardless of smear results, with 66% of positive and 62% of negative smears being associated with one or more symptoms. The most commonly reported symptoms were diarrhea (43%), abdominal discomfort (32%), urgency (27%), tenesmus (18%), nausea (18%), and stool mucus (10%).

“Overall, we found a high rate of detection of intestinal pathogens in HIV-negative MSM who took PrEP, with 45% of participants having at least one positive rectal swab during the study period,” the authors write. “With these concerns in mind, sexual health testing strategies should consider using multiplex PCR screening for GI pathogens in MSM with GI symptoms, and asymptomatic screening may be beneficial in high prevalence or outbreak situations.”

ADD SUBJECT TO EMAIL ALERTS

Receive an email when new articles are published on

Please enter your email address to receive an email when new articles are published on . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If this problem persists, please contact [email protected].

Back to Healio