{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T18:21:32Z","timestamp":1785781292997,"version":"3.56.0"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.15217.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T00:00:00Z","timestamp":1591228800000}},{"DOI":"10.12688\/wellcomeopenres.15217.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T00:00:00Z","timestamp":1591228800000}},{"DOI":"10.12688\/wellcomeopenres.15217.3","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T00:00:00Z","timestamp":1591228800000}}],"reference-count":45,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T00:00:00Z","timestamp":1591228800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009250","name":"New Partnership for Africa's Development","doi-asserted-by":"publisher","award":["DEL-15-006"],"award-info":[{"award-number":["DEL-15-006"]}],"id":[{"id":"10.13039\/501100009250","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002992","name":"Department for International Development, UK Government","doi-asserted-by":"publisher","award":["DEL-15-006"],"award-info":[{"award-number":["DEL-15-006"]}],"id":[{"id":"10.13039\/501100002992","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000866","name":"International AIDS Vaccine Initiative","doi-asserted-by":"publisher","award":["IAV-IAV03"],"award-info":[{"award-number":["IAV-IAV03"]}],"id":[{"id":"10.13039\/100000866","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI124968"],"award-info":[{"award-number":["R01AI124968"]}],"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":["R01AI24968"],"award-info":[{"award-number":["R01AI24968"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011858","name":"African Academy of Sciences","doi-asserted-by":"publisher","award":["DEL-15-006"],"award-info":[{"award-number":["DEL-15-006"]}],"id":[{"id":"10.13039\/501100011858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["203077"],"award-info":[{"award-number":["203077"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Robert W. Anderson Endowed Professorship"},{"name":"Sub-Saharan African Network for TB\/HIV Research Excellence"}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Men who have sex with men (MSM) have a higher prevalence of\n                    <ns4:italic>Chlamydia trachomatis<\/ns4:italic>\n                    (CT) and\n                    <ns4:italic>Neisseria gonorrhoeae<\/ns4:italic>\n                    (NG) infections compared to the rest of the population, often remaining undiagnosed. In Kenya, prevalence of rectal CT and NG infection and NG antimicrobial sensitivity are poorly described.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    MSM who reported receptive anal intercourse (RAI) were recruited from an ongoing human immunodeficiency virus acquisition and treatment study in coastal Kenya in 2016-2017. Rectal swabs were collected at two time points 6 months apart to estimate prevalence and incidence of CT\/NG infection using a molecular point-of-care assay. Participants positive for CT or NG were treated according to national guidelines. NG culture and antimicrobial susceptibility testing was performed. Participant and risk behaviour characteristics were collected and association with baseline CT\/NG prevalence assessed by multivariable regression analysis.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    Prevalence of CT\/NG in 104 MSM was 21.2% (CT 13.5%, NG 9.6%, dual infection 1.9%) at baseline and 25.9% in 81 MSM at follow-up (CT 14.8%, NG 14.8%, dual infection 3.7%). CT\/NG incidence was estimated at 53.0 (95% CI, 34.5-81.3) per 100 person-years. Most CT\/NG positive participants were asymptomatic: 95.5% at baseline and 100% at follow-up. CT\/NG infection was associated with being paid for sex [adjusted odds ratio (aOR)=6.2, 95% CI (1.7-22.9)] and being in formal employment [aOR=7.5, 95% CI (1.1-49.2)]. Six NG isolates were obtained at follow-up; all were susceptible to ceftriaxone and cefixime and all were resistant to penicillin, tetracycline and ciprofloxacin.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    There is a high prevalence and incidence of asymptomatic rectal CT and NG in MSM reporting RAI in coastal Kenya. MSM who were paid for sex or had formal employment were more likely to be infected with CT\/NG suggesting increased risk behaviour during transactional sex. Antimicrobial susceptibility results suggest that current antibiotic choices in Kenya are appropriate for NG treatment.\n                  <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.15217.4","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T09:20:06Z","timestamp":1591262406000},"page":"79","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Rectal gonorrhoea and chlamydia among men who have sex with men in coastal Kenya"],"prefix":"10.12688","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8827-7685","authenticated-orcid":false,"given":"Caroline J.","family":"Ngetsa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc W.","family":"Heymann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Thiong'o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8386-7555","authenticated-orcid":false,"given":"Elizabeth","family":"Wahome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3986-4503","authenticated-orcid":false,"given":"John","family":"Mwambi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Karani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson C.","family":"Menza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Mwashigadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3721-1587","authenticated-orcid":false,"given":"Margaret W.","family":"Muturi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7847-8686","authenticated-orcid":false,"given":"Susan M.","family":"Graham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1808-3292","authenticated-orcid":false,"given":"Peter M.","family":"Mugo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1062-8921","authenticated-orcid":false,"given":"Eduard 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Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-79\/v4\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-79\/v4\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-79\/v4\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T03:55:15Z","timestamp":1593143715000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-79\/v4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,4]]},"references-count":45,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.15217.4","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.17530.r38968","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.17530.r38968","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,4]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-79\/v4#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.16606.r35502, Michael W. Ross, Program in Human Sexuality, Department of Family Medicine, University of Minnesota Medical School, Minneapolis, MN, USA, 28 May 2019, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-79\/v1#referee-response-35502","order":0,"name":"referee-response-35502","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Caroline Ngetsa<\/b>; \n<i>Posted: 17 Dec 2019<\/i>; Dear Reviewers,Many thanks for your comments on our manuscript. We have responded to each individually and reflect the changes in the amended manuscript.\n<i>This is a useful report of rectal gonorrhea and chlamydia in MSM in coastal Kenya. The Introduction suffers from missing some crucial findings from a similar study of prevalence of rectal NG\/CT in MSM in Tanga and Dar es Salaam, a few hundred miles south of where this study was carried out (Ross MW et al., BMJ Open&nbsp;2014)<\/i>\n<i>1<\/i>\n<i>. Some of those interesting findings were replicated, including the lack of association between HIV and STI in MSM, plus similar high rates of rectal STIs. There may be lessons here about access to clinics that will perform rectal examinations\/swabs, especially if the MSM are not &quot;out&quot; to health care workers (rectal STIs are a marker for MSM activity and likely to engender discriminatory behavior in many health workers). Religion was given for 77%, but what was the other quarter? Hindi? No religion?&nbsp;<\/i>\n<b>Thank you for your review. We have now referred to the study in Dar Es Salaam and Tanga in the background and discussion sections of this manuscript. The point of discussion regarding access to clinics is also very relevant; we feel that we do raise this issue a bit in our introduction and discussion, by raising issues with stigma related to MSM in general; this should encompass healthcare access as well. <\/b>\n<b>We have also written down the religious background of the remaining quarter of participants; this is also visible in Table 1.<\/b>\n<i>This is an important study, with the gaps noted above. It would also have been helpful to briefly speculate as to what bias might have been associated with recruiting participants from an existing high-risk cohort study.<\/i>\n<b>Thank you for noting this. We have included details of eligible patients who were not included in the study (and have included data available on <i>figshare<\/i>, a link is available in the References of the manuscript): importantly, it was noted that patients not included in the study had higher risk behaviour. This is unlikely to underestimate true infection prevalence and rate within this population.<\/b>","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-79\/v4#referee-comment-4033","order":1,"name":"referee-comment-4033","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.17530.r38968, Nicola Low, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland, 26 Jun 2020, version 4, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-79\/v4#referee-response-38968","order":2,"name":"referee-response-38968","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was partially funded by the International AIDS Vaccine Initiative (IAVI) with the generous support of USAID and other donors; a full list of IAVI donors is available at www.iavi.org. KWTRP is supported by core funding from the Wellcome Trust (203077). SMG was supported by NIH grant R01AI24968 and the Robert W. Anderson Endowed Professorship in Medicine. EJS receives research funding from IAVI, NIH (grant R01AI124968), and the Wellcome Trust. This work was also supported through the Sub-Saharan African Network for TB\/HIV Research Excellence (SANTHE), a DELTAS Africa Initiative [grant # DEL-15-006]. The contents are the responsibility of the study authors and do not necessarily reflect the views of USAID, the NIH, the United States Government or the Wellcome Trust. This report was published with permission from KEMRI. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}