{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T16:13:09Z","timestamp":1779120789185,"version":"3.51.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 AI113185"],"award-info":[{"award-number":["K23 AI113185"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AI175153"],"award-info":[{"award-number":["R01 AI175153"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rectal sexually transmitted infections (STIs) are commonly diagnosed among men who have sex with men (MSM), but limited prospective data exist on the rectal symptomatology associated with these infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>In 2016\u20132018, we enrolled 140 MSM in a 48-week cohort study in Seattle, Washington. Participants self-collected weekly rectal specimens that were tested at the end of the study for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC), and Mycoplasma genitalium (MG) using nucleic acid amplification tests. Participants reported rectal symptoms (rectal discharge, pain, itching, blood in stool, and pain on defecation) in a weekly survey. We calculated the adjusted relative risk (aRR) of the association between incident rectal STIs and rectal symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants reported rectal symptoms during 12 (38%) of 32 incident rectal CT infections, 6 (30%) of 20 incident rectal GC infections, and 9 (60%) of 15 incident rectal MG infections. Rectal symptoms were significantly more likely to be reported during weeks when participants tested positive for CT, GC, or MG (8.1% [44\/544]) compared to weeks when specimens tested negative for all 3 (3.9% [97\/2456]) (aRR = 3.01; 95% CI = 1.77\u20135.13). Rectal itching was the most common symptom during weeks when participants tested either positive (4.6%) or negative (1.7%); rectal discharge was rare (&amp;lt;1% of weeks). The median duration of symptoms was 1 week for CT and GC and 3 weeks for MG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rectal symptoms are common among persons with rectal GC, CT, and MG infections but are typically mild and of short duration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag276","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T11:30:56Z","timestamp":1777980656000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, Duration, and Severity of Rectal Symptoms Among Men Who Have Sex With Men With Rectal Sexually Transmitted Infections"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2673-5969","authenticated-orcid":false,"given":"Shengruo","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7189-5492","authenticated-orcid":false,"given":"Lindley A","family":"Barbee","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"HIV\/STI\/HCV Program , Public Health\u2013Seattle & King County, Seattle, Washington ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olusegun O","family":"Soge","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Department of Global Health, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Department of Laboratory Medicine & Pathology, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7449-3774","authenticated-orcid":false,"given":"Matthew R","family":"Golden","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Department of Medicine, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"HIV\/STI\/HCV Program , Public Health\u2013Seattle & King County, Seattle, Washington ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4896-7654","authenticated-orcid":false,"given":"Lisa E","family":"Manhart","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Department of Global Health, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9743-0829","authenticated-orcid":false,"given":"Christine M","family":"Khosropour","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"2026051811514298100_ofag276-B1","author":"World Health Organization"},{"key":"2026051811514298100_ofag276-B2","doi-asserted-by":"crossref","first-page":"5758387","DOI":"10.1155\/2016\/5758387","article-title":"Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature","volume":"2016","author":"Chan","year":"2016","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2026051811514298100_ofag276-B3","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1097\/OLQ.0000000000001170","article-title":"Extragenital gonorrhea and chlamydia positivity and the potential for missed extragenital gonorrhea with concurrent urethral chlamydia among men who have sex with men attending sexually transmitted disease clinics-sexually transmitted disease surveillance network, 2015\u20132019","volume":"47","author":"Abara","year":"2020","journal-title":"Sex Transm Dis"},{"key":"2026051811514298100_ofag276-B4","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/OLQ.0000000000000754","article-title":"Prevalence of rectal chlamydial and gonococcal infections: a systematic review","volume":"45","author":"Dewart","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2026051811514298100_ofag276-B5","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1136\/sextrans-2019-054310","article-title":"Prevalence of Mycoplasma genitalium by anatomical site in men who have sex with men: a systematic review and meta-analysis","volume":"96","author":"Latimer","year":"2020","journal-title":"Sex Transm Infect"},{"key":"2026051811514298100_ofag276-B6","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1086\/430704","article-title":"Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003","volume":"41","author":"Kent","year":"2005","journal-title":"Clin Infect Dis"},{"key":"2026051811514298100_ofag276-B7","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1097\/OLQ.0b013e318177ec39","article-title":"Prevalence of rectal Trichomonas vaginalis and Mycoplasma genitalium in male patients at the San Francisco STD clinic, 2005\u20132006","volume":"35","author":"Francis","year":"2008","journal-title":"Sex Transm 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