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Basic & Translational Science

Category: Gonorrhoea - general

(P82) High burden of urogenital gonorrhea and low HIV prevalence in young Ugandan men with urethral discharge syndrome: An opportunity for STI and HIV prevention interventions

Tuesday, July 25, 2023
16:00 – 18:00 CST
Background

Adolescents and young people are disproportionately affected by HIV and other sexually transmitted infections (STIs). Neisseria gonorrhoeae (Ng), a marker for unprotected sex, increases HIV transmission risk. Few studies have looked at Ng and HIV prevalence among this population in low- and middle-income countries (LMIC). There is need for more research to inform targeted STI and HIV prevention strategies.

Methods

Between October 2019 and July 2022, 450 men seeking treatment for urethral discharge syndrome (UDS) from six clinics in Kampala, Uganda were recruited. Urogenital swabs and blood were collected and tested for Ng using culture on selective agar; HIV was tested for using the HIV/Syphilis SD Bioline assay (Standard Diagnostic Inc., Korea) with confirmatory algorithmic testing. Demographic, clinical and behavioral data were collected using questionnaires and used to explore associations with Ng and HIV by age categories (< vs ≥25 years) using Chi 2.

Results

Table 1 describes characteristics of study participants by age category. Of 450 participants, median age 24 years [22.0-32.0], 52.7% (n=237) were < 25 years. Younger men were more likely to have ≥3 sexual partners (p=0.011) with 9.3% and 7.5% reporting transactional sex in < 25 Vs ≥ 25 years respectively. Condom use was poor across both groups with 48.5% in < 25 and 49.3% in ≥ 25 years never using condoms. HIV prevalence was 4.7% and 33.7% in those < and ≥ 25 years respectively (p< 0.001) with 7.5% being new HIV diagnoses; new HIV diagnoses were much more common in men < 25 years. Ng positivity was higher in those < 25 (64.6%) vs >25 (52.5%) (p=0.035).

Conclusion

Integrated HIV and Ng testing found higher Ng prevalence and undiagnosed HIV among younger men aged < 25 years. Integrated testing for Ng and HIV in men with UDS should be systematically strengthened to improve case finding for both infections and presents a good opportunity for targeted HIV and STI prevention interventions.