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Published on: March 24, 2023
Sexual behaviors and risk of extended-spectrum β-lactamase-producing Enterobacterales carriage: A cross-sectional
Anders Boyd1, Pauline Mathieu2, Ugo Françoise3
1Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France; Stichting HIV Monitoring, Amsterdam, The Netherlands; Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
Objectives:
Sexual transmission of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) is suspected. We aimed to identify clusters of sexual behavior associated with ESBL-E carriage among individuals at risk of sexually transmitted infections (STI).
Methods:
In this cross-sectional study, patients attending an STI-screening center and human immunodeficiency virus outpatient clinic in Paris, France between 2018 and 2019 were asked questions on the following sexual activities in the last 6 months: receptive/insertive anal intercourse, passive/active rimming, receptive/insertive fellatio, receptive/insertive fisting, receptive/insertive fingering, active/passive cunnilingus. ESBL-E carriage was determined from rectal swabs. Bayesian latent class analysis was used to identify clusters of sexual activity, which were then associated with ESBL-E carriage using logistic regression.
Results:
Among 1211 men who have sex with men (MSM), those belonging to two latent classes with higher prevalence of insertive fingering and active rimming (ESBL-E prevalence=15.3%, N = 124 and 16.0%, N = 100) and one class with higher proportions of all behaviors (24.3%, N = 70) had a higher risk of ESBL-E carriage compared to those in a class with few sexual behaviors (7.3%, N = 259) after adjustment. Among 439 other men and 479 women, no clear associations between sexual clusters and ESBL-E carriage were observed.
Conclusions:
Sexual behaviors are associated with varying degrees of ESBL-E carriage, particularly among MSM.
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