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Area of Science:

  • Infectious Diseases
  • Public Health
  • Sexual Health

Background:

  • Acute proctitis diagnosis relies on identifying at-risk groups, understanding symptoms, and performing risk stratification through sexual history.
  • Cases are concentrated in adolescents, young adults, men who have sex with men, and transgender women, with disproportionately high rates among Black adolescents due to healthcare access barriers.

Purpose of the Study:

  • To outline the diagnostic criteria and risk factors for acute proctitis.
  • To emphasize the importance of timely screening and management in vulnerable populations.

Main Methods:

  • Review of clinical presentation and epidemiological data for acute proctitis.
  • Risk stratification based on sexual history, including condomless anal sex, oral intercourse, and number of partners.
  • Recommendations for multisite sexually transmitted infection (STI) testing.

Main Results:

  • Key symptoms include purulent discharge, bleeding, pain, tenesmus, pruritus, altered bowel habits, weight loss, or fever.
  • High-risk groups identified: adolescents (15-19), young adults (20-24), men who have sex with men, transgender women, and individuals with a history of human immunodeficiency virus (HIV) infection.
  • Black adolescents face a disproportionately high burden due to concentrated cases and healthcare access issues.

Conclusions:

  • Comprehensive sexual history and risk stratification are essential for accurate acute proctitis diagnosis.
  • Management strategies include promoting barrier protection, pre-exposure prophylaxis (PrEP), routine surveillance, partner notification, and access to preventive immunizations.
  • Addressing healthcare access barriers is critical to reduce disparities in Black adolescents.