{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:56:01Z","timestamp":1781067361210,"version":"3.54.1"},"reference-count":32,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["19275"],"award-info":[{"award-number":["19275"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["Del-22-007"],"award-info":[{"award-number":["Del-22-007"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIH","award":["R01AI179838"],"award-info":[{"award-number":["R01AI179838"]}]},{"DOI":"10.13039\/100000866","name":"International AIDS Vaccine Initiative","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000866","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-033558"],"award-info":[{"award-number":["INV-033558"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,16]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the prevalence, incidence and factors associated with <jats:italic>Chlamydia trachomatis<\/jats:italic> (CT) and <jats:italic>Neisseria gonorrhoeae<\/jats:italic> (NG) infection among HIV-negative men who have sex with men (MSM) and transgender women (TGW) in Kenya.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Kisumu, Nairobi and coastal Kenya.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>650 young adult participants (570 MSM and 80 TGW) recruited at three research clinics. Inclusion criteria were HIV-negative status, age 18\u201329 years, assigned male sex at birth, identification as cisgender male or transgender female and reported anal intercourse with a man in the past 3 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>Urine, rectal and oropharyngeal samples were tested for CT\/NG infection at two different time points (\u223c6 months apart), using nucleic acid amplification. We compared CT\/NG prevalence and incidence in MSM versus TGW and used Poisson regression to compare risk for each group after adjustment for other correlates of prevalent and incident CT\/NG infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Prevalence of CT\/NG infection at any anatomic site was 15.8% and 27.5% in MSM and TGW, respectively (p=0.009). CT\/NG incidence was 27.2 (95% CI 21.3 to 34.7) and 24.5 (95% CI 12.3 to 49.0) per 100 person years for MSM and TGW, respectively (p=0.784). In multivariable analysis, there was no difference in prevalence or incidence by gender identity. Baseline CT\/NG infection was more prevalent among TGW (adjusted prevalence ratio 1.61, 95%\u2009CI 0.99 to 2.62). Incident CT\/NG infection was increased among participants with baseline CT\/NG infection (adjusted incidence rate ratio (aIRR) 3.14, 95%\u2009CI 1.94 to 5.07) and self-reported pre-exposure prophylaxis use (aIRR 1.75, 95%\u2009CI 1.04 to 2.93).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Despite higher prevalence of CT\/NG infections among TGW at baseline, there were no differences in CT\/NG prevalence and incidence between TGW and MSM, after adjustment for potential confounders. Improved condom use, effective partner notification and treatment, and new strategies such as doxycycline post-exposure prophylaxis are needed to reduce CT\/NG infections in both MSM and TGW in settings where regular testing is not possible.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-098916","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T09:01:42Z","timestamp":1754038902000},"page":"e098916","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Chlamydia and gonorrhoea infections in young Kenyan HIV-negative cisgender men who have sex with men and transgender women: a multicentre cohort study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1062-8921","authenticated-orcid":false,"given":"Eduard J","family":"Sanders","sequence":"first","affiliation":[{"name":"Implementation Science Division, The Aurum Institute for Health 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Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan","family":"Okall","sequence":"additional","affiliation":[{"name":"Nyanza Reproductive Health Society, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Nzioka","sequence":"additional","affiliation":[{"name":"University of Nairobi, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evans","family":"Gichuru","sequence":"additional","affiliation":[{"name":"KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise M","family":"van der Elst","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C","family":"Bailey","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Illinois at Chicago, Chicago, 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