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. 2022 Oct 1;49(10):669-676.
doi: 10.1097/OLQ.0000000000001685. Epub 2022 Jul 29.

Effect of Screening and Treatment for Gonorrhea and Chlamydia on HIV Incidence Among Men Who Have Sex With Men in the United States: A Modeling Analysis

Jeb Jones  1 , Adrien Le Guillou  1 , Thomas L Gift  2 , Harrell Chesson  2 , Kyle T Bernstein  2 , Kevin P Delaney  2 , Cynthia Lyles  2 , Andres Berruti  2 , Patrick S Sullivan  1 , Samuel M Jenness  1
Affiliations

Effect of Screening and Treatment for Gonorrhea and Chlamydia on HIV Incidence Among Men Who Have Sex With Men in the United States: A Modeling Analysis

Jeb Jones et al. Sex Transm Dis. .

Abstract

Background: Previous models have estimated the total population attributable fraction of Neisseria gonorrhoeae and Chlamydia trachomatis (NG/CT) on HIV incidence among men who have sex with men (MSM), but this does not represent realistic intervention effects. We estimated the potential impact of screening for NG/CT on downstream incidence of HIV among MSM.

Methods: Using a network model, we estimated the effects of varying coverage levels for sexually transmitted infection screening among different priority populations: all sexually active MSM regardless of HIV serostatus, MSM with multiple recent (past 6 months) sex partners regardless of serostatus, MSM without HIV, and MSM with HIV. Under the assumption that all screening events included a urethral test, we also examined the effect of increasing the proportion of screening events that include rectal screening for NG/CT on HIV incidence.

Results: Increasing annual NG/CT screening among sexually active MSM by 60% averted 4.9% of HIV infections over a 10-year period (interquartile range, 2.8%-6.8%). More HIV infections were averted when screening was focused on MSM with multiple recent sex partners: 60% coverage among MSM with multiple recent sex partners averted 9.8% of HIV infections (interquartile range, 8.1%-11.6%). Increased sexually transmitted infection screening among MSM without HIV averted more new HIV infections compared with the transmissions averted because of screening MSM with HIV, but fewer NG/CT tests were needed among MSM with HIV to avert a single new HIV infection.

Conclusions: Screening of NG/CT among MSM is expected to lead to modest but clinically relevant reductions in HIV incidence among MSM.

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Conflict of interest statement

Conflict of Interest and Sources of Funding: None declared.

References

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