Sexually Transmitted Infection Positivity Among Adolescents With or at High-Risk for Human Immunodeficiency Virus Infection in Los Angeles and New Orleans.
Chelsea L Shannon, Erin M Keizur, Anne Fehrenbacher, Drew Wood-Palmer, Wilson Ramos, Maryann Koussa, Jasmine Fournier, Sung-Jae Lee, Dhara Patel, Whitney N Akabike, Sue Ellen Abdalian, Mary Jane Rotheram-Borus, Jeffrey D Klausner, Adolescent Trials Network (ATN) CARES Team
Author Information
Chelsea L Shannon: From the Division of Infectious Diseases.
Erin M Keizur: From the Division of Infectious Diseases.
Anne Fehrenbacher: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA.
Drew Wood-Palmer: From the Division of Infectious Diseases.
Wilson Ramos: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA.
Maryann Koussa: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA.
Jasmine Fournier: Department of Pediatrics/Adolescent Medicine, Tulane University School of Medicine, New Orleans, LA.
Sung-Jae Lee: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA.
Dhara Patel: Department of Health Policy and Management.
Whitney N Akabike: Department of Community Health Sciences, University of California, Los Angeles, CA, USA.
Sue Ellen Abdalian: Department of Pediatrics/Adolescent Medicine, Tulane University School of Medicine, New Orleans, LA.
Mary Jane Rotheram-Borus: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA.
Jeffrey D Klausner: From the Division of Infectious Diseases.
BACKGROUND: Gay, bisexual, and transgender youth and homeless youth are at high risk for sexually transmitted infections (STIs). However, little recent data exist describing STI positivity by anatomical site among those groups. We determined the positivity of Chlamydia trachomatis (CT) infection, Neisseria gonorrhoeae (NG) infection, and syphilis antibody reactivity among lesbian, gay, bisexual, transgender, and homeless youth. METHODS: We recruited 1,264 adolescents with high risk behavior aged 12 to 24 years from homeless shelters, lesbian, gay, bisexual, and transgender organizations, community health centers, and using social media and online dating apps in Los Angeles, California and New Orleans, Louisiana from May 2017 to February 2019. Participants received point-of-care pharyngeal, rectal, and urethral/vaginal CT and NG testing and syphilis antibody testing. We calculated STI positivity by anatomical site and compared positivity by participant subgroups based on human immunodeficiency virus (HIV) status, sex assigned at birth, and gender identity. RESULTS: CT and NG positivity and syphilis antibody reactivity was higher among HIV-infected adolescent men who have sex with men (MSM) than HIV-uninfected adolescent MSM (40.2% vs. 19%, P < 0.05), particularly CT or NG rectal infection (28% vs. 12.3%, P < 0.05). Of participants with positive CT or NG infections, 65% had extragenital-only infections, 20% had both extragenital and urogenital infections, and 15% had urogenital-only infections. CONCLUSIONS: Sexually Transmitted Infection positivity was high, particularly among transgender women and MSM. The high proportion of rectal and pharyngeal infections highlights the importance of both urogenital and extragenital STI screening. More accessible STI testing is necessary for high-risk adolescent populations.
