TUPDC0106

Title

Prospective, multicenter study to assess point prevalence, incidence and recurrence of sexually transmitted infections in men who have sex with men in Germany: BRAHMS study

Presenter

Hendrik Streeck

Authors

H. Streeck¹, K. Janssen², T.A. Crowell³, H. Jessen⁴, C. Cordes⁵, S. Scholten⁶, S. Schneeweiss⁶, N. Brockmeyer⁷, C. Spinner⁸, M. Bickel⁹, S. Esser¹⁰, J. Hartikainen¹¹, A. Stoehr¹², C. Lehmann¹³, U. Marcus², J.-J. Vehreschild¹³, A.-L. Brillen¹, C. Tiemann¹⁴, M.L. Robb³, N.L. Michael³

Institutions

¹Institute for HIV Research, Essen, Germany, ²Robert Koch Institute, Berlin, Germany, ³U.S. Military HIV Research Program, Bethesda, United States, ⁴Private Practice Jessen+Jessen, Berlin, Germany, ⁵Private Practice Cordes, Berlin, Germany, ⁶Private Practice Hohenstaufenring, Cologne, Germany, ⁷Walk im Ruhr (WiR), Bochum, Germany, ⁸Technical University of Munich, Munich, Germany, ⁹Infektiologikum Frankfurt, Frankfurt, Germany, ¹⁰HPSTD clinic, University Duisburg-Essen, Essen, Germany, ¹¹MVZ Diesener Str., Berlin, Germany, ¹²institute for interdisciplinary medicine, Hamburg, Germany, ¹³University of Cologne, Cologne, Germany, ¹⁴Laboratory Krone, Bad Salzuflen, Germany

Background: Rates of new HIV infections in Germany are moderately declining, and knowledge on impact of novel HIV prevention methods, such as HIV pre-exposure prophylaxis (PrEP), including its impact on sexual transmitted infections (STI) are sparse.
Here we report on a prospective, multicenter study to assess point prevalence, incidence and recurrence of STIs in 1000 men who have sex with men (MSM) at risk for HIV infection.
Methods: The BRAHMS study is a prospective study conducted at ten sites in 7 major German cities enrolling MSM at risk for HIV infection. Participants are seen every three months and systematically screened for all STIs including HIV, HAV, HBV, HCV, Gonorrhea (NG), Syphilis (TP), Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) among others. Diagnosis was performed from blood samples as well as urine, anal swab, and oropharyngeal swab specimens. Sexual behavior questionnaires are assessed at each time point.
Results: Among participants at risk for HIV infection we found high point prevalence of sexually transmitted infections (NG: 10%, CT, 13% MG 20%, TP 5%). Overall seropositivity for TP was 20.3%, which includes participants with a positive EIA and history of previously-treated disease. In addition, we found a point prevalence of HIV and acute HCV infection of each 0.5%. 25% of participants were positive for more than one STI. Over 90% of STI cases were asymptomatic. CT, MG and GO infections were predominantly rectal (CT:67%; MG:59%; GO:43%), while GO was also frequently pharyngeal (CT: 15%; MG: 14%; GO 43%). 68% of individuals at risk for HIV infection initiated PrEP. There were no significant differences in the point prevalence of STIs in individuals that already took PrEP before enrollment into the study and non-PrEP users. All HIV infections were detected in non-PrEP users.
Conclusions: We detected high frequencies of asymptomatic, rectal STIs in MSM but low point prevalence of previously undiagnosed HIV infection.

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