Prevalence of sexually transmissible infections and HIV in men attending sex-on-premises venues in Australia: a systematic review and meta-analysis of observational studies
Catriona Ooi A B F , Fabian Y. S. Kong C , David A. Lewis D E and Jane S. Hocking C
+ Author Affiliations
- Author Affiliations
A Clinic 16, 2C Herbert Street, St Leonards, NSW 2065, Australia.
B Northern Clinical School, Faculty of Health and Medicine, University of Sydney, Sydney, NSW 2006, Australia.
C Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Parkville, Vic. 3010, Australia.
D Western Sydney Sexual Health Centre, 162 Marsden Street, Parramatta, NSW 2150, Australia.
E Westmead Clinical School, Faculty of Health and Medicine & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Darcy Road, Westmead, NSW 2145, Australia.
F Corresponding author. Email: catriona.ooi@health.nsw.gov.au
Sexual Health 17(2) 135-148 https://doi.org/10.1071/SH19150
Submitted: 30 August 2019 Accepted: 23 December 2019 Published: 31 March 2020
Abstract
Background: In Australia, men who have sex with men (MSM) have high rates sexually transmissible infections (STIs) and sex-on-premises venue (SOPV) patrons are at risk. This paper assesses Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), syphilis and HIV prevalence in men tested at Australian SOPVs and describes testing services. Methods: EMBASE, Medline, PubMed and international conference proceedings were searched for articles reporting on-site SOPV testing between 1 January 2000 and 31 January 2017. Meta-analysis calculated pooled prevalence estimates of STIs by anatomical site. Results: Twelve cross-sectional studies were identified. Most (8/12) were local sexual health clinics (SHC) outreach services. Participants’ mean age was 41.1 years (95% confidence interval (CI) 37.0–43.3; range 17 to 84 years). Testing included CT and NG (9/12), HIV (8/12) and syphilis (5/12). CT and NG prevalence overall summary estimates were 3.4% (95% CI 1.9–5.2%, I2 = 88.7%, P < 0.01) and 1.3% (95% CI 0.7–2.2%, I2 = 75.5%, P < 0.01) respectively. CT and NG prevalence was highest in the ano-rectum and oro-pharynx respectively. The HIV and syphilis pooled estimates were 2.3% (95% CI 1.6–2.9%, I2 = 93.1%, P < 0.01) and 3.2% (95% CI 1.8–4.6%, I2 = 72.8%, P < 0.01) respectively. Participation rate varied. Conclusion: This review examines HIV and STI testing in Australian SOPVs before HIV pre-exposure prophylaxis (PrEP). Findings indicate a high prevalence of STIs. PrEP use and resultant condomless sex may influence STI prevalence. Further research is required to determine the effect of PrEP on the STI prevalence among SOPV patrons.
Additional keywords: chlamydia, gonorrhoea, outreach, screening, syphilis.
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