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Racial/ethnic and sexual behavior disparities in rates of sexually transmitted infections, San Francisco, 1999-2008.

Scott HM, Bernstein KT, Raymond HF, Kohn R, Klausner JD - BMC Public Health (2010)

Bottom Line: Asian/Pacific Islander MSM consistently had the lowest rate among MSM with 1003 cases per 100,000 in 2008.For all racial/ethnic groups in San Francisco, MSM carried a substantially higher burden of STIs compared to non-MSM except among African-American men.These racial and sexual behavior disparities warrant further public health attention and resources.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, University of California, San Francisco, California, USA. hyman.scott@ucsf.edu

ABSTRACT

Background: Racial/ethnic minorities and men who have sex with men (MSM) represent populations with disparate sexually transmitted infection (STI) rates. While race-specific STI rates have been widely reported, STI rates among MSM is often challenging given the absence of MSM population estimates. We evaluated the race-specific rates of chlamydia and gonorrhea among MSM and non-MSM in San Francisco between 1999-2008.

Methods: 2000 US Census data for San Francisco was used to estimate the number of African-American, Asian/Pacific Islander, Hispanic, and white males. Data from National HIV Behavioral Surveillance (NHBS) MSM 1, conducted in 2004, was used to estimate the total number of MSM in San Francisco and the size of race/ethnic sub-populations of MSM. Non-MSM estimates were calculated by subtracting the number of estimated MSM from the total number of males residing in San Francisco. Rates of MSM and non-MSM gonorrhea and chlamydia reported between 1999 and 2008 were stratified by race/ethnicity. Ratios of MSM and non-MSM rates of morbidity were calculated by race/ethnicity.

Results: Between 1999-2008, MSM accounted for 72% of gonorrhea cases and 51% of chlamydia cases. Throughout the study period, African-American MSM had the highest chlamydia rate with 606 cases per 100,000 in 1999 increasing to 2067 cases per 100,000 in 2008. Asian/Pacific Islander MSM consistently had the lowest rate among MSM with 1003 cases per 100,000 in 2008. The ratio of MSM/non-MSM for chlamydia was highest among whites 11.6 (95% CI: 8.8-14.4) and Asian/Pacific Islanders 8.6 (95% CI: 6.2-11), and lowest among African-Americans 1.53 (95% CI: 1.2-1.9) and Hispanics 4.43 (95% CI: 2.8-6.0). Gonorrhea rates were similar for African-American, white, and Hispanic MSM between 2137-2441 cases per 100,000 in 2008. Asian/Pacific Islander MSM had the lowest gonorrhea rate with 865 cases per 100,000 in 2008. The ratio of MSM/non-MSM for gonorrhea was highest among whites 11.6 (95% CI: 8.8-14.4) and Asian/Pacific Islanders 8.6 (95% CI: 6.2-11), and lowest among African-Americans 1.53 (95% CI: 1.2-1.9) and Hispanics 4.43 (95% CI: 2.8-6.0).

Conclusions: For all racial/ethnic groups in San Francisco, MSM carried a substantially higher burden of STIs compared to non-MSM except among African-American men. These racial and sexual behavior disparities warrant further public health attention and resources.

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Related in: MedlinePlus

Rates of gonorrhea among men in San Francisco, 1999-2008. (A) Cases of gonorrhea among men who have sex with men (MSM) per 100,000. (B) Cases of chlamydia among non-MSM per 100,000.
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Figure 3: Rates of gonorrhea among men in San Francisco, 1999-2008. (A) Cases of gonorrhea among men who have sex with men (MSM) per 100,000. (B) Cases of chlamydia among non-MSM per 100,000.

Mentions: Rates of gonorrhea among MSM increased between 1999 and 2008 (Figure 3A). In 2008, African-Americans and Whites had similar rates of gonorrhea at 2360 per 100,000 and 2441 cases per 100,000 respectively. Hispanics had similarly high rates of gonorrhea (2137 cases per 100,000) and Asian/Pacific Islanders had the lowest gonorrhea rates (865 cases per 100,000) in 2008. Among non-MSM, African-Americans had case rates of gonorrhea at least five fold higher than all other racial groups during the study period (Figure 3B). The rate ratio of MSM/non-MSM was highest among Asian/Pacific Islanders 36.8 (95% CI: 26.9-46.7) and Whites 28.5 (95% CI: 20.4-36.57), and lowest among African-Americans 2.9 (95% CI: 2.1-3.7) and Hispanics 16.8 (95% CI: 10.9-22.7) (Figure 4).


Racial/ethnic and sexual behavior disparities in rates of sexually transmitted infections, San Francisco, 1999-2008.

Scott HM, Bernstein KT, Raymond HF, Kohn R, Klausner JD - BMC Public Health (2010)

Rates of gonorrhea among men in San Francisco, 1999-2008. (A) Cases of gonorrhea among men who have sex with men (MSM) per 100,000. (B) Cases of chlamydia among non-MSM per 100,000.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2903517&req=5

Figure 3: Rates of gonorrhea among men in San Francisco, 1999-2008. (A) Cases of gonorrhea among men who have sex with men (MSM) per 100,000. (B) Cases of chlamydia among non-MSM per 100,000.
Mentions: Rates of gonorrhea among MSM increased between 1999 and 2008 (Figure 3A). In 2008, African-Americans and Whites had similar rates of gonorrhea at 2360 per 100,000 and 2441 cases per 100,000 respectively. Hispanics had similarly high rates of gonorrhea (2137 cases per 100,000) and Asian/Pacific Islanders had the lowest gonorrhea rates (865 cases per 100,000) in 2008. Among non-MSM, African-Americans had case rates of gonorrhea at least five fold higher than all other racial groups during the study period (Figure 3B). The rate ratio of MSM/non-MSM was highest among Asian/Pacific Islanders 36.8 (95% CI: 26.9-46.7) and Whites 28.5 (95% CI: 20.4-36.57), and lowest among African-Americans 2.9 (95% CI: 2.1-3.7) and Hispanics 16.8 (95% CI: 10.9-22.7) (Figure 4).

Bottom Line: Asian/Pacific Islander MSM consistently had the lowest rate among MSM with 1003 cases per 100,000 in 2008.For all racial/ethnic groups in San Francisco, MSM carried a substantially higher burden of STIs compared to non-MSM except among African-American men.These racial and sexual behavior disparities warrant further public health attention and resources.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, University of California, San Francisco, California, USA. hyman.scott@ucsf.edu

ABSTRACT

Background: Racial/ethnic minorities and men who have sex with men (MSM) represent populations with disparate sexually transmitted infection (STI) rates. While race-specific STI rates have been widely reported, STI rates among MSM is often challenging given the absence of MSM population estimates. We evaluated the race-specific rates of chlamydia and gonorrhea among MSM and non-MSM in San Francisco between 1999-2008.

Methods: 2000 US Census data for San Francisco was used to estimate the number of African-American, Asian/Pacific Islander, Hispanic, and white males. Data from National HIV Behavioral Surveillance (NHBS) MSM 1, conducted in 2004, was used to estimate the total number of MSM in San Francisco and the size of race/ethnic sub-populations of MSM. Non-MSM estimates were calculated by subtracting the number of estimated MSM from the total number of males residing in San Francisco. Rates of MSM and non-MSM gonorrhea and chlamydia reported between 1999 and 2008 were stratified by race/ethnicity. Ratios of MSM and non-MSM rates of morbidity were calculated by race/ethnicity.

Results: Between 1999-2008, MSM accounted for 72% of gonorrhea cases and 51% of chlamydia cases. Throughout the study period, African-American MSM had the highest chlamydia rate with 606 cases per 100,000 in 1999 increasing to 2067 cases per 100,000 in 2008. Asian/Pacific Islander MSM consistently had the lowest rate among MSM with 1003 cases per 100,000 in 2008. The ratio of MSM/non-MSM for chlamydia was highest among whites 11.6 (95% CI: 8.8-14.4) and Asian/Pacific Islanders 8.6 (95% CI: 6.2-11), and lowest among African-Americans 1.53 (95% CI: 1.2-1.9) and Hispanics 4.43 (95% CI: 2.8-6.0). Gonorrhea rates were similar for African-American, white, and Hispanic MSM between 2137-2441 cases per 100,000 in 2008. Asian/Pacific Islander MSM had the lowest gonorrhea rate with 865 cases per 100,000 in 2008. The ratio of MSM/non-MSM for gonorrhea was highest among whites 11.6 (95% CI: 8.8-14.4) and Asian/Pacific Islanders 8.6 (95% CI: 6.2-11), and lowest among African-Americans 1.53 (95% CI: 1.2-1.9) and Hispanics 4.43 (95% CI: 2.8-6.0).

Conclusions: For all racial/ethnic groups in San Francisco, MSM carried a substantially higher burden of STIs compared to non-MSM except among African-American men. These racial and sexual behavior disparities warrant further public health attention and resources.

Show MeSH
Related in: MedlinePlus