By Ismael Maatouk, Moubadda Assi and Rusi Jaspal
The prevalence of HIV in Lebanese men who have sex with men (MSM) is estimated to be 12% and the prevalence of having at least one symptom of sexually transmitted infection (STI) is 34.9%. This is in line with the high-risk behavioural profile among this community where HIV testing rates are low, unprotected sex is frequent, alcohol and substance use is reported to be high. Our new piece in BMJ Sexual and Reproductive Health, presents data on the prevalence of STIs in a sample of MSM attending a sexual health clinic in Beirut to identify the correlates of risk-taking and testing behaviours in this population.
What we did
We analyzed data from the medical records of MSM who presented for STI screening and treatment between 2014 and 2018 at a sexual health center (Dermatology-STI clinic) in Beirut, Lebanon. Medical records also include data from a short survey filled before the consultation. Ethical approval was obtained from the Faculty of Health & Life Sciences Research Ethics Committee, De Montfort University, Leicester, United Kingdom.
What we found
A total of 1364 participants who had complete data were included in the analysis. In line with our first objective, the profile of STIs in this sample was determined and genital warts (condylomas) were by far the most common STI with almost half of all patients receiving such a diagnosis. Chlamydia trachomatis was detected in just over a quarter of the sample. Less frequent were other diagnosis of STIs like anogenital herpes, Neisseria gonorrhea, syphilis, scabies/pediculosis, HIV, Mycoplasma genitalium, hepatitis B, lymphogranuloma venereum and hepatitis C. This profile of STIs among MSM in Lebanon is the first to be reported in such a large sample.
To assess the predictors of STI screening, our second objective, participants were divided into 2 groups: those who had never been screened and those who had had at least one previous screening. Those who had been screened had a higher frequency of:
- alcohol/ substance use
- use of mobile phone applications for casual sex
- perceived HIV risk
- unprotected sex.
Our results suggest that people who are aware of their risk behavior are more likely to be tested. We believe that a campaign to raise awareness and to promote discussion of sexual health is warranted. These discussions can include substance use in sexualized settings (or chemsex), sexual networks and dating applications usage, and PrEP.
Addressing these questions is crucial to reduce the incidence of HIV/STIs and thereby enhance sexual health outcomes among this high-risk Lebanese population.
How can we enhance sexual health outcomes in men who have sex with men in Lebanon? By Ismael Maatouk, Moubadda Assi, and Rusi Jaspal was published in BMJ Sexual and Reproductive Health