{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:22:58Z","timestamp":1790140978799,"version":"4.0.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Concurrent sexually transmitted infections (STIs) are common in sexually active populations. We aimed to estimate the prevalence and coinfection rates of bacterial STIs among sexually active, HIV-positive men who have sex with men (MSM), and to assess the potential benefits of different combination treatment regimens in managing concurrent bacterial STIs.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n From September 2021 to September 2023, HIV-positive MSM underwent STI testing when they had symptoms suggestive of STIs or recently acquired hepatitis C virus (HCV) infection or early syphilis. The oral rinse, rectal swab, and urethral swab specimens were tested for\n Chlamydia trachomatis<\/jats:italic>\n ,\n Neisseria gonorrhoeae<\/jats:italic>\n ,\n Mycoplasma<\/jats:italic>\n spp.,\n Ureaplasma<\/jats:italic>\n spp., and\n Trichomonas vaginalis<\/jats:italic>\n with the use of multiplex real-time polymerase-chain-reaction assays. The estimated coinfection rates were used to evaluate the benefits of different combination treatment regimens for managing coinfections.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During the study period, 535 participants (median age, 37\u2009years; and CD4 count, 615 cells\/mm\n 3<\/jats:sup>\n ) were enrolled. On their first visits, at least one bacterial pathogen was detected in 57.9% and concomitant bacterial infections were found in 32.9% of the participants. The most commonly identified pathogen was\n U. urealyticum<\/jats:italic>\n (36.3%), followed by\n C. trachomatis<\/jats:italic>\n (22.8%), and\n N. gonorrhoeae<\/jats:italic>\n (19.8%). The factors associated with any bacterial STIs included older age (per 1-year increase, adjusted odds ratio [AOR], 0.97; 95% confidence interval [CI], 0.95\u20131.00), early syphilis (AOR, 1.87; 95% CI, 1.22\u20132.84), and having more than 5 sex partners in the preceding 3\u2009months (AOR, 2.08, 95% CI, 1.07\u20134.06). A combination therapy of benzathine penicillin G with a 7-day course of doxycycline could simultaneously treat 27.1% of\n C. trachomatis<\/jats:italic>\n coinfections in participants with early syphilis, while a combination therapy of ceftriaxone with doxycycline could simultaneously treat 40.6% of chlamydial coinfections in participants with gonorrhea.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Bacterial STIs were prevalent and concomitant infections were not uncommon among sexually active, HIV-positive MSM, supporting regular screening for bacterial STIs. The effectiveness of preemptive use of doxycycline as combination therapy for concurrent STIs warrants more investigations.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2024.1328589","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:33:48Z","timestamp":1710462828000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatment"],"prefix":"10.3389","volume":"11","author":[{"given":"Tzong-Yow","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Yin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Hsin","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Yun","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Shan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang-Da","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Chun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan-Hsin","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sui-Yuan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Ching","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e396","DOI":"10.1016\/S2352-3018(19)30043-8","article-title":"Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV","volume":"6","author":"Chow","year":"2019","journal-title":"Lancet HIV"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s12879-020-4831-4","article-title":"Group MSMSS. STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany","volume":"20","author":"Jansen","year":"2020","journal-title":"BMC Infect Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"719","DOI":"10.3201\/eid2504.181258","article-title":"Symptoms, sites, and significance of Mycoplasma genitalium in men who have sex with men","volume":"25","author":"Read","year":"2019","journal-title":"Emerg Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1016\/j.jfma.2020.12.008","article-title":"High prevalence of sexually transmitted coinfections among at-risk people living with HIV","volume":"120","author":"Lin","year":"2021","journal-title":"J Formos Med Assoc"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e624","DOI":"10.1093\/cid\/ciaa293","article-title":"Prevalence of Mycoplasma genitalium infection, antimicrobial resistance mutations, and symptom resolution following treatment of urethritis","volume":"71","author":"Bachmann","year":"2020","journal-title":"Clin Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e113771","DOI":"10.1371\/journal.pone.0113771","article-title":"Are Ureaplasma spp. a cause of nongonococcal urethritis? A systematic review and meta-analysis","volume":"9","author":"Zhang","year":"2014","journal-title":"PLoS One"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1111\/andr.12078","article-title":"Mycoplasma and ureaplasma infection and male infertility: a systematic review and meta-analysis","volume":"3","author":"Huang","year":"2015","journal-title":"Andrology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"178","DOI":"10.7326\/0003-4819-139-3-200308050-00007","article-title":"Chlamydia trachomatis among patients infected with and treated for Neisseria gonorrhoeae in sexually transmitted disease clinics in the United States","volume":"139","author":"Lyss","year":"2003","journal-title":"Ann Intern Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e87","DOI":"10.1097\/OLQ.0000000000001605","article-title":"Coinfection with chlamydial and gonorrheal infection among US adults with early syphilis","volume":"49","author":"Dionne-Odom","year":"2022","journal-title":"Sex Transm Dis"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"11087","DOI":"10.1038\/s41598-021-90627-3","article-title":"Modelling the multiple anatomical site transmission of Mycoplasma genitalium among men who have sex with men in Australia","volume":"11","author":"Xu","year":"2021","journal-title":"Sci Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1186\/s12916-020-01796-3","article-title":"Chlamydia trachomatis transmission between the oropharynx, urethra and anorectum in men who have sex with men: a mathematical model","volume":"18","author":"Xu","year":"2020","journal-title":"BMC Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually transmitted infections treatment guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm Rep"},{"key":"ref13","year":"2020"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1111\/jdv.17972","article-title":"2021 European guideline on the management of Mycoplasma genitalium infections","volume":"36","author":"Jensen","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e0243721","DOI":"10.1128\/spectrum.02437-21","article-title":"Three-stage pooled plasma hepatitis C virus RNA testing for the identification of acute HCV infections in at-risk populations","volume":"10","author":"Sun","year":"2022","journal-title":"Microbiol Spectr"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"333","DOI":"10.3855\/jidc.15279","article-title":"Comparison of two commercial multiplex PCR assays for the detection of sexually transmitted infections","volume":"16","author":"Yassin","year":"2022","journal-title":"J Infect Dev Ctries"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.3390\/diagnostics12051141","article-title":"Evaluation of a multiplex real-time PCR assay for detecting Chlamydia trachomatis in vaginal samples","volume":"12","author":"Kebbi-Beghdadi","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1684\/abc.2018.1360","article-title":"Accreditation of a multiplex real time PCR assay for detection and semi-quantitative determination of pathogens responsible of sexually-transmitted infections","volume":"76","author":"Robinet","year":"2018","journal-title":"Ann Biol Clin (Paris)"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s15010-019-01386-3","article-title":"Prevalence and antibiotic resistance of rectal mollicutes in HIV-infected men who have sex with men at the University Hospital of Dresden, Germany","volume":"48","author":"Spornraft-Ragaller","year":"2020","journal-title":"Infection"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.jiac.2019.12.007","article-title":"Prevalence of N. gonorrhoeae, C. trachomatis, M. genitalium, M. Hominis and Ureaplasma spp. in the anus and urine among Japanese HIV-infected men who have sex with men","volume":"26","author":"Kato","year":"2020","journal-title":"J Infect Chemother"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.jmii.2022.08.009","article-title":"Performance of two commercial multiplex polymerase chain reaction assays for the etiological diagnosis of sexually transmitted infections among men who have sex with men","volume":"56","author":"Lee","year":"2023","journal-title":"J Microbiol Immunol Infect"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1177\/0956462415597620","article-title":"Ureaplasma parvum and Mycoplasma genitalium are found to be significantly associated with microscopy-confirmed urethritis in a routine genitourinary medicine setting","volume":"27","author":"Cox","year":"2016","journal-title":"Int J STD 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Dis"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1186\/s12889-018-6092-3","article-title":"The use of geosocial networking smartphone applications and the risk of sexually transmitted infections among men who have sex wit hmen: a systematic review and meta-analysis","volume":"18","author":"Wang","year":"2018","journal-title":"BMC Public Health"},{"key":"ref28","doi-asserted-by":"publisher","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":"ref29","doi-asserted-by":"publisher","first-page":"e25354","DOI":"10.1002\/jia2.25354","article-title":"The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission","volume":"22","author":"Chow","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1177\/09564624211047477","article-title":"Triple site sexually transmitted infection testing as a crucial component of surveillance for men who have sex with men: a prospective cohort study","volume":"33","author":"Zucker","year":"2022","journal-title":"Int J STD AIDS"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1016\/j.jmii.2023.01.007","article-title":"Characteristics of rectal chlamydia among men who have sex with men in southern Taiwan, 2020-2022: an emerging threat of rectal lymphogranuloma venereum L2b","volume":"56","author":"Tsai","year":"2023","journal-title":"J Microbiol Immunol Infect"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1128\/JCM.02460-15","article-title":"The \"3 in 1\" study: pooling self-taken pharyngeal, urethral, and rectal samples into a single sample for analysis for detection of Neisseria gonorrhoeae and Chlamydia trachomatis in men who have sex with men","volume":"54","author":"Sultan","year":"2016","journal-title":"J Clin Microbiol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"ciad 508","DOI":"10.1093\/cid\/ciad508","article-title":"Higher serologic responses of early syphilis to single-dose benzathine penicillin G plus doxycycline versus single-dose benzathine penicillin G alone among people with HIV","volume":"27","author":"Chen","year":"2023","journal-title":"Clin Infect Dis"},{"key":"ref34","article-title":"Doxy PEP and antimicrobial resistance in Neisseria gonorrhoeae, commensal Neisseria and Staphylococcus aureus","author":"Luetkemeyer","year":"2023"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1093\/jac\/dkad129","article-title":"Important considerations regarding the widespread use of doxycycline chemoprophylaxis against sexually transmitted infections","volume":"78","author":"Kong","year":"2023","journal-title":"J Antimicrob Chemother"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1328589\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:33:52Z","timestamp":1710462832000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1328589\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,15]]},"references-count":35,"alternative-id":["10.3389\/fmed.2024.1328589"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1328589","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,15]]},"article-number":"1328589"}}