Background: 

Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) may be at high risk for bacterial sexually transmitted infections (STIs). We examined the prevalence of extragenital gonorrhea and chlamydia by PrEP status among a multisite sample of US MSM.

Methods: 

MSM aged ≥18 years were recruited through venue-based sampling to participate in the 2017 National HIV Behavioral Surveillance. In 5 cities (San Francisco, Washington DC, New York City, Miami, and Houston), participants completed a questionnaire, HIV testing, and pharyngeal and rectal STI specimen self-collection. We measured prevalence of pharyngeal and rectal gonorrhea and chlamydia among self-reported non–HIV-positive MSM who reported using or not using PrEP in the previous 12 months.

Results: 

Overall, 29.6% (481/1627) of non–HIV-positive MSM reported PrEP use in the past year. MSM who reported PrEP use were more likely to have any STI (ie, extragenital gonorrhea and/or chlamydia) than MSM not on PrEP [14.6% vs. 12.0%, adjusted prevalence ratio (aPR) = 1.5, 95% confidence interval (CI) : 1.1 to 2.0], reflecting differences in rectal chlamydia prevalence (8.7% vs. 6.0%, aPR = 1.6, 95% CI: 1.1 to 2.4). PrEP use was not associated with pharyngeal chlamydia, pharyngeal gonorrhea, or rectal gonorrhea.

Conclusions: 

The prevalence of extragenital STI was high for both MSM on PrEP and those not on PrEP in the past year. MSM on PrEP were more likely to have rectal chlamydia but not pharyngeal STIs or rectal gonorrhea. Our findings support regular STI testing at exposed anatomic sites as recommended for sexually active MSM, including those on PrEP.

中文翻译：

---

在美国与男性发生性行为的男性中，暴露前预防性使用和检测到的性传播感染—美国艾滋病毒行为监测，美国5个城市，2017年

背景： 

使用HIV暴露前预防（PrEP）与男性发生性行为（MSM）的男性可能具有细菌性传播感染（STIs）的高风险。我们通过美国MSM多站点样本中的PrEP状况检查了生殖器外 淋病和衣原体的患病率。

方法： 

年龄≥18岁的MSM通过场所抽样入选，参加了2017年全国HIV行为监测。在5个城市（旧金山，华盛顿特区，纽约，迈阿密和休斯敦），参与者完成了问卷调查，HIV测试以及咽和直肠STI标本的自我收集。我们测量了在过去12个月内报告使用或未使用PrEP的自我报告的非HIV阳性MSM中咽，直肠淋病和衣原体的患病率。

结果： 

总体而言，在过去一年中，有29.6％（481/1627）的非HIV阳性MSM报告了PrEP的使用。MSM谁报告PrEP的使用更可能具有任何STI（即，生殖器外 淋病和/或衣原体），比不MSM上的PrEP [14.6％对12.0％，调整患病率之比（APR）= 1.5，95％置信区间（CI ）：1.1至2.0]，反映了直肠衣原体患病率的差异（8.7％与6.0％，aPR = 1.6，95％CI：1.1至2.4）。PrEP的使用与咽衣原体，咽淋病或直肠淋病无关。

结论： 

普遍存在的生殖器官 STI是高两个MSM对PrEP的和那些不上的PrEP在过去的一年。PrEP上的MSM更可能患有直肠衣原体感染，而咽STIs或直肠淋病没有。我们的发现支持对性活跃的MSM（包括PrEP上的性行为）推荐的在暴露的解剖部位进行常规STI测试。