5. Screen for sexually transmitted infections, including HIV
Rates of HIV infection, early syphilis (primary, secondary, or early latent), gonorrhea, and chlamydia continue to rise among MSM in LA County and nationally.1,3 Among MSM, new HIV infections are associated with recent or concurrent STDs, particularly early syphilis.1 In LA County, 80% of early syphilis cases occurred among MSM.4
MSM in LA County remain at disproportionate risk for HIV acquisition and transmission, accounting for 85% of all new HIV diagnoses. LAC DPH estimates that the high rates of HIV infections among MSM are a result of the high rates of HIV infection among young (ages 18 – 29) black/African-American MSM.4
Clinicians should routinely ask male patients about STD-related risks, including the gender of their sex partners. MSM, including those with HIV infection, should be asked about risky sexual behaviors and offered STD and HIV testing and risk reduction counseling. As many infections are asymptomatic and substantial numbers of MSM remain unaware of their HIV serostatus (up to 44% in one recent survey of young men in minority populations),5 routine STD and HIV screening is important.
The LAC DPH STD Screening Recommendations provide population screening recommendations, guidance on how to perform a brief sexual risk assessment, and information on risk factors that indicate the need for more frequent screening among MSM and other groups. The following is adapted from these recommendations.