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High burden of bacterial sexually transmitted infections among young men who have sex with men and transgender women in Thailand

Title
High burden of bacterial sexually transmitted infections among young men who have sex with men and transgender women in Thailand
Presenter
Narukjaporn Thammajaruk
Authors
N. Thammajaruk * (1), S. Chumseng (1), O. Nampaisan (1), N. Photisan (1), J. Peelay (1), P. Srivachiraroj (1), S. Promthong (1), F. Suwan (2), P. Boonyawan (3), N. Thammueanyong (4), N. Thanmarak (5), M. Avery (6), S. Mills (6), P. Phanuphak (1), N. Phanuphak (1), R. A. Ramautarsing (1)
Institutions
(1) Institute of HIV Research and Innovation (IHRI), Bangkok, Thailand, (2) Service Workers In Group Foundation, Bangkok, Thailand, (3) Rainbow Sky Association of Thailand, Bangkok, Thailand, (4) Mplus Foundation, Chiang Mai, Thailand, (5) Service Workers In Group Foundation Pattaya, Chonburi, Thailand, (6) FHI 360, Bangkok, Thailand

BACKGROUND: The burden of sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and syphilis among key populations (KPs) in Thailand is not well assessed, especially among young men who have sex with men (MSM) and transgender women (TGW). To increase access to STI services for KPs, we integrated CT/NG testing by GeneXpert into key population-led health services (KPLHS) in four community-based organizations (CBOs) in Thailand. We report STI prevalence and incidence among MSM and TGW by age.
METHODS: Thai MSM and TGW '¥18 years, with at least one HIV risk in the past 6 months (unprotected anal intercourse, >5 sexual partners, history of STIs, and/or use of stimulant drugs), were enrolled. Single participant pooled urine, pharyngeal, and rectal samples, collected by trained KP-lay providers or self-collection, were used for CT/NG testing. Plasma was used for syphilis serology (SD BIOLINE Syphilis 3.0 and rapid plasma reagin). Data from August 2019 to July 2020 were used to calculate STI prevalence and incidence (reported per 100 person-years ' PY).
RESULTS: 875 (86.8%) MSM and 133 (13.2%) TGW enrolled. Among 240 MSM <24 years, prevalence of any STI/CT/NG/syphilis was 107 (44.6%)/71 (29.7%)/51 (21.3%)/26 (10.8%), incidence was 38.8/24.8/14.4/13.6 per 100PY. Among 295 MSM 24-29 years, prevalence of any STI/CT/NG/syphilis was 114 (38.6%)/70 (23.8%)/58 (19.7%)/30 (10.2%), incidence was 44.6/23.9/25.4/4.7 per 100PY. Among 340 MSM '¥30 years, prevalence of any STI/CT/NG/syphilis was 111 (32.7%)/65 (19.1%)/45 (13.2%)/36 (10.6%), incidence was 43.8/23.9/26.6/7.1 per 100PY. Among 27 TGW <24 years, prevalence of any STI/CT/NG/syphilis was 14 (51.9%)/11 (40.7%)/4 (14.8%)/3 (11.1%), incidence was 59.4/60.7/0/0 per 100PY. Among 45 TGW 24-29 years, prevalence of any STI/CT/NG/syphilis was 13 (28.9%)/9 (20.0%)/5 (11.1%)/7 (15.6%), incidence was 30.3/21.9/10.7/13.8 per 100PY. Among 61 TGW '¥30 years, prevalence of any STI/CT/NG/syphilis was 15 (24.6%)/9 (14.8%)/9 (14.8%)/5 (8.2%), incidence was 24.7/16.4/16.4/0 per 100PY.
CONCLUSIONS: After integrating CT/NG testing into KPLHS at CBOs in Thailand, we observed high burden of STIs among MSM and TGW, especially among young KPs. Routine STI prevention, screening, and management should be offered to all KPs, with particular emphasis on reaching and facilitating service uptake among young MSM and TGW.