Prevalence and predictors of lymphogranuloma venereum among men who have sex with men at a Sydney metropolitan sexual health clinic
David J. Templeton A B C E , Nicola Sharp A , Sophie Gryllis D , Catherine C. O’Connor A B C and Sally M. Dubedat DA RPA Sexual Health, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.
B The Kirby Institute, The University of New South Wales, Sydney, NSW 2052, Australia.
C Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW 2006, Australia.
D Department of Microbiology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.
E Corresponding author. Email: david.templeton@email.cs.nsw.gov.au
Submitted: 24 August 2012 Accepted: 21 October 2012 Published: 1 March 2013
Abstract
During an 18-month period to June 2012, 1732 anal chlamydia (Chlamydia trachomatis) tests were performed among men who have sex with men (MSM) at RPA Sexual Health in Sydney’s inner west. Positive anal chlamydia samples were subsequently tested for lymphogranuloma venereum (LGV). Seventy-five (4.3%) anal samples were positive for chlamydia among 67 men during the study period. Anal symptoms were reported for 16 out of 75 (21.3%) of anal chlamydia episodes overall. Three episodes of LGV (all serovar L2b) were identified, all three of whom reported anal symptoms (100%, 95% confidence interval (CI): 29.2–100%). In contrast, only 13/72 (18.1%, 95% CI: 10.0–28.9%) of those with non-LGV anal chlamydia reported anal symptoms. LGV was not identified in any of 59 episodes of asymptomatic anal chlamydia (0%, 95% CI: 0–6.1%). Of those with LGV, two were known to be HIV-positive and one subsequently seroconverted to HIV within a year of the LGV diagnosis. Our findings suggest that routine LGV testing among MSM is not warranted, except among those with anal symptoms.
Additional keywords: Australia, chlamydia, gay men, HIV/AIDS, risk behaviours.
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