Molecular Screening in a Longitudinal Cohort of Young Men Who Have Sex with Men and Young Transgender Women: Associations with Focus on the Emerging Sexually Transmitted Pathogen

Objectives: This investigation sought to characterise risk factors associated with acquisition of traditional and emerging agents of sexually transmitted infection (STI) in a cohort of young men who have sex with men and transgender women.

Methods: 917 participants provided urine and rectal swab submissions assessed by transcription-mediated amplification (TMA)-based assays for and and by off-label TMA-based and testing. A subset provided specimens at 6-month and 12-month follow-up visits.

Results: Prevalence of from rectal and urine specimens (21.7% and 8.9%, respectively) exceeded that of (8.8% and 1.6%) and other STI agents. Black participants yielded higher prevalence of (30.6%) than non-black participants (17.0%; χ²=22.39; p<0.0001). prevalence from rectal specimens was 41.5% in HIV-positive participants vs 16.3% in HIV-negative participants (χ²=57.72; p<0.0001). Participant age, gender identity, condomless insertive anal/vaginal sexual practice and condomless receptive anal sexual practice were not associated with rectal (p≥0.10), (p≥0.29), (p≥0.18) or (p≥0.20) detection. While prevalence of was calculated at ≤1.0%, baseline rectal and urine screening status was predictive of detection/non-detection at follow-up. A non-reactive baseline rectal or urine screening result was less predictive of non-reactive follow-up versus , and .

Conclusions: Rectal detection is associated with black race and HIV seropositivity. Baseline infection influences subsequent detection of the organism.