P17 Female sex workers in Ecuador have high prevalence of isolated rectal sexually transmitted infections: a call for new testing strategies. (16th June 2022)

• Record Type: Journal Article
• Authors: Broad, Claire E; Llangari Arizo, Luz Marina; Zhou, Liqing; Mateo, Miguel Martin; Cooper, Philip; Romero-Sandoval, Natalia; Sadiq, Syed Tariq
• Is Part Of: Sexually transmitted infections. Volume 98(2022)Supplement 1
• Page Start: A33
• Page End: A33
• Publication Date: 2022-06-16
• Subjects: Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-BASHH-2022.64
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Introduction: Female sex workers in Ecuador (FSWE) undertake high-risk behaviours including extra-genital sex but data on sexually transmitted infections (STI) are few, with limited genital STI-testing 1 . Genital testing alone may identify Trichomonas vaginalis (TV) but may miss oropharyngeal and anorectal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Mycoplasma gentialium (MG) infections. We assessed prevalence and risk factors associated with non-viral genital and extra-genital STIs in FSWE. Methods: FSWE aged ≥18 years were recruited from three north-west Ecuadorian settlements. 250 FSWE provided: responses to a validated socio-demographic questionnaire and investigator-collected vulvo-vaginal (VVS), rectal and pharyngeal swabs. Real-time PCR was used to detect CT, NG, MG from all swabs and TV from VVS. Risk factors were analysed using univariate and multivariate logistic regression. Results: Prevalence of at least one of: CT, NG, MG, or TV vaginally, was 32.0% (95%CI:26.5-38.0); and CT, NG, or MG in the anorectum and oropharynx was 20.5% (15.9-26.1) and 2.8% (1.4-5.7), respectively ( Table ). Anorectal CT, NG, MG prevalence was 11.2% (7.4-16.0), 5.9% (CI:3.4-9.8) and 6.7% (4.0-11.0); 60.0% (42.3-75.4), 68.8% (44.4-85.8) and 32.0% (17.2-51.6) of these infections respectively were isolated anorectal. In multivariate analyses having any vaginal STI (p<0.001) was the only risk factor predicting anorectal STI; reported anal sex with partners or clients was not. Discussion: High prevalence of isolated anorectal STIs in FSWE, suggest exclusive genital testing would miss significant CT and NG infections. The lack of associated anorectal STI risk factors further suggests new testing approaches for all FSWE should be investigated, including pooled multi-anatomical site sampling. Reference: Llangarí-Arizo LM, Sadiq ST, Márquez C, et al. Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city. PLoS One. 2021;16(5):e0250117. Published 2021 May 6. doi:10.1371/journal.pone.0250117