Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infection in men attending STD clinics in Brazil

Introduction: The study aimed to assess the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections and identify demographic, behavioral and clinical factors correlated with such infections in men attending six sexually transmitted disease clinics in Brazil. Methods: Multicentric, cross-sectional study performed among men attending STD clinics in Brazil. The study included STD clinics in six cities distributed throughout the five geographic regions of Brazil in 2005. Patients provided 20 ml of first catch urine for testing for NG and CT by DNA-PCR. Results: A total of 767 (92.9%) men were included in the study. The mean age was 26.5 (SD 8.3) years-old. Prevalence of Chlamydia infection was 13.1% (95% CI 10.7%-15.5%) and gonorrhea was 18.4% (95% CI 15.7%-21.1%). Coinfection prevalence was 4.4% (95% CI 2.95%-5.85%) in men who sought attendance in STI clinics. Factors identified as associated with C. trachomatis were younger age (15-24) [OR=1.4 (95% CI 1.01-1.91)], present urethral discharge [OR=4.8 (95% CI 1.52-15.05)], genital warts [OR=3.0 (95% CI 1.49-5.92)] and previous history of urethral discharge [OR=2.4 (95% CI 1.11-5.18)]. Variables associated with gonorrhea were younger age (15 to 24) [OR=1.5 (95% CI 1.09-2.05)], presence of urethral discharge [OR=9.9 (95% CI 5.53-17.79)], genital warts [OR=18.3 (95% CI 8.03-41.60)] and ulcer present upon clinical examination [OR=4.9 (95% CI 1.06-22.73)]. Conclusions: These findings have important implications for education and prevention actions directed toward men at risk of HIV/STD. A venue-based approach to offer routine screening for young men in STD clinics should be stimulated.