Bacterial sexually transmitted infection testing and diagnoses among men who have sex with men and report prescription opioid misuse––American Men's Internet Survey, 2017–2018

• Type of Material: Article
• Authors: Winston E Abara, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Maria Zlotorzynska, Emory University; Robert D Kirkcaldy, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Travis Sanchez, Emory University
• Language: English
• Date: 2021-06-01
• Publisher: Elsevier B.V.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.annepidem.2021.02.002
• Title of Journal or Parent Work: Annals of Epidemiology
• Volume: 58
• Start Page: 1
• End Page: 6
• Grant/Funding Information: This study was supported by AHRQ (R01HS026232) and the National Institute of Nursing Research, National Institutes of Health (R01NR014855).
• Keywords: STD diagnoses; Internet; Opioid-Related Disorders; STD testing; Sexually Transmitted Diseases; Prevalence; Sexual Behavior; Male; Syphilis; Humans; Sexual and Gender Minorities; Sexually Transmitted Diseases, Bacterial; Homosexuality, Male; HIV Infections; United States; Prescription opioid misuse; Gonorrhea; Surveys and Questionnaires; Chlamydia
• Research Categories: Health Sciences, Epidemiology

Abstract

Purpose: Prescription opioid misuse is associated with behaviors which increase bacterial sexually transmitted diseases (STD) risk among men who have sex with men (MSM). Annual syphilis, gonorrhea, and chlamydia screening is recommended for sexually active MSM at anatomical sites of contact, regardless of condom use. We describe the prevalence of self-reported bacterial STD testing and diagnoses in the past 12 months among sexually active MSM who report prescription opioid misuse. Methods: We used data from the 2017 and 2018 American Men's Internet Survey to examine the prevalence of self-reported bacterial STD testing and diagnoses in the past 12 months. We calculated unadjusted prevalence ratios, adjusted prevalence ratios (APR), and 95% confidence intervals (CI) to compare bacterial STD testing prevalence across demographic, clinical, and behavioral factors. Results: Of 932 sexually active MSM who reported prescription opioid misuse, 433 (46.5%) self-reported bacterial STD testing in the past 12 months. Of those who reported being tested, 131 (30.2%) self-reported ≥ 1 bacterial STD. Approximately 50% of respondents who reported condomless anal sex (CAS), casual sex, or exchange sex reported bacterial STD testing in past 12 months. Factors associated with bacterial STD testing among MSM who misused prescription opioids included visiting a healthcare provider in the past 12 months (APR = 1.70, 95% CI = 1.09–2.67), ever disclosing same-sex behavior to a healthcare provider (APR = 1.78, 95% CI = 1.27–2.50), and CAS in the past 12 months (APR = 1.51, 95% CI = 1.10–2.04). Conclusions: Prevalence of self-reported bacterial STD testing in this sample was low and one-third of tested MSM reported ≥ 1 bacterial STD in the past 12 months. Innovative approaches to identify MSM who misuse prescription opioids and expand bacterial STD testing in this population are needed.