Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis Infections among Thai Adolescents and Young Adult Men Who Have Anal Sex: Targeted Screening Strategy
Paramate Tanthawet¹, Poramitta Padungkiattisak², Taweesak Sritammasiri², Juthamanee Moonwong², Prissana Wongharn², Lucksanapon Pitikawinwong², Pathariya Promsena²,³, Wipaporn Natalie Songtaweesin²,⁴,⁵, Suvaporn Anugulruengkitt²,⁴, Thanyawee Puthanakit²,⁴
Affiliation : ¹ King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; ² Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok, Thailand; ³ Affiliated Researcher at Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; ⁴ Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; ⁵ School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective: Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), are common among adolescents and young adults (AYA). The present study aimed to examine the prevalence of NG and CT among AYA using a targeted strategy for high-risk populations and to explore associated risk factors for these Sexually transmitted infections (STIs).
Materials and Methods: A cross-sectional study was conducted at an STI clinic in Bangkok. The inclusion criteria were 1) aged between 15 to 24 years, 2) engaging in anal sex, and 3) at high risk of STI acquisition, such as more than three sex partners in the preceding six months having symptoms of urethritis or proctitis. STI screening was performed using pooled specimens collected from urethral, anal, and throat swabs. Nucleic acid amplification tests (NAATs) for NG and CT were performed using GeneXpert assays.
Results: Between May 2023 and April 2024, 150 Thai AYA with a median age of 22 years (IQR 20 to 23) were enrolled. Forty-four participants (29.3%) presented with symptomatic STIs, 23 (15.3%) were living with HIV. The overall prevalence of NG or CT was 38.7% (95% CI 30.8 to 47.0). The prevalence of NG and CT were 21.3% (95% CI 15.1 to 28.8) and 23.3% (95% CI 16.8 to 30.9), respectively. Factors associated with NG infection were being both insertive and receptive sex partners (adjusted prevalence ratio [aPR] 3.1, 95% CI 1.2 to 7.5) and diagnosed with STIs in the preceding year (aPR 2.6, 95% CI 1.0 to 6.5) while factors associated with CT infection was living with HIV (PR 2.7, 95% CI 1.0 to 7.0).
Conclusion: About one-thirds of AYA who have anal sex had NG or CT infections. Reporting sexual roles as both insertive and receptive partners, a previous diagnosis of STI in the preceding year, and living with HIV increased the likelihood of having STIs. Targeted screening among AYA with these profiles should be considered.
Received 20 December 2024 | Revised 11 April 2025 | Accepted 28 April 2025
DOI: 10.35755/jmedassocthai.2025.7.520-525-02261
Keywords : Neisseria gonorrhoeae; Chlamydia trachomatis; Sexually transmitted infections; Adolescents and young adults; Prevalence; Sexual roles; Living with HIV
