Detection of rectal chlamydia trachomatis in heterosexual men who report cunnilingus

Teresa Batteiger, Stephen J. Jordan, Evelyn Toh, Lora Fortenberry, James A. Williams, Michelle Lapradd, Barry Katz, J. Fortenberry, Brian Dodge, Janet Arno, Byron Batteiger, David E. Nelson

Research output: Contribution to journalArticle

Abstract

Background Rectal infection with Chlamydia trachomatis (CT) is frequent in women who deny receptive anal sex and is thought to arise from autoinoculation of the rectum from vaginal secretions. An alternate hypothesis is that oral sex inoculates and establishes gastrointestinal tract infection. Distinguishing these hypotheses is difficult in women. In men, autoinoculation is unlikely and heterosexual men frequently perform oral sex, but rarely participate in receptive anal exposure behaviors. Methods We enrolled high-risk men with and without nongonococcal urethritis who presented to a sexually transmitted infection clinic in Indianapolis, Indiana. Urine and rectal swabs were collected and tested for urogenital and rectal CT, Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG). Men completed surveys concerning symptoms, sexual orientation, and detailed recent and lifetime oral and anal sexual behaviors. Results Rectal CT was detected in 2/84 (2.4%) heterosexual men who reported cunnilingus, but no lifetime receptive anal behaviors. All of the men who denied receptive anal behaviors were negative for rectal NG and MG. In homosexual and bisexual men, rectal CT prevalence was high (9.7%), and rectal NG (4.8%) and MG (4.8%) were also detected. Conclusions We detected rectal CT infections in heterosexual men who reported cunnilingus but denied receptive anal behaviors. Oral sex may be a risk factor for rectal CT infection via oral inoculation of the gastrointestinal tract.

Original languageEnglish (US)
Pages (from-to)440-445
Number of pages6
JournalSexually Transmitted Diseases
Volume46
Issue number7
DOIs
StatePublished - Jul 1 2019

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Chlamydia trachomatis
Heterosexuality
Sexual Behavior
Mycoplasma genitalium
Neisseria gonorrhoeae
Chlamydia Infections
Gastrointestinal Tract
Urethritis
Sexually Transmitted Diseases
Infection
Rectum
Urine

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Batteiger, T., Jordan, S. J., Toh, E., Fortenberry, L., Williams, J. A., Lapradd, M., ... Nelson, D. E. (2019). Detection of rectal chlamydia trachomatis in heterosexual men who report cunnilingus. Sexually Transmitted Diseases, 46(7), 440-445. https://doi.org/10.1097/OLQ.0000000000000998

Detection of rectal chlamydia trachomatis in heterosexual men who report cunnilingus. / Batteiger, Teresa; Jordan, Stephen J.; Toh, Evelyn; Fortenberry, Lora; Williams, James A.; Lapradd, Michelle; Katz, Barry; Fortenberry, J.; Dodge, Brian; Arno, Janet; Batteiger, Byron; Nelson, David E.

In: Sexually Transmitted Diseases, Vol. 46, No. 7, 01.07.2019, p. 440-445.

Research output: Contribution to journalArticle

Batteiger, Teresa ; Jordan, Stephen J. ; Toh, Evelyn ; Fortenberry, Lora ; Williams, James A. ; Lapradd, Michelle ; Katz, Barry ; Fortenberry, J. ; Dodge, Brian ; Arno, Janet ; Batteiger, Byron ; Nelson, David E. / Detection of rectal chlamydia trachomatis in heterosexual men who report cunnilingus. In: Sexually Transmitted Diseases. 2019 ; Vol. 46, No. 7. pp. 440-445.
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abstract = "Background Rectal infection with Chlamydia trachomatis (CT) is frequent in women who deny receptive anal sex and is thought to arise from autoinoculation of the rectum from vaginal secretions. An alternate hypothesis is that oral sex inoculates and establishes gastrointestinal tract infection. Distinguishing these hypotheses is difficult in women. In men, autoinoculation is unlikely and heterosexual men frequently perform oral sex, but rarely participate in receptive anal exposure behaviors. Methods We enrolled high-risk men with and without nongonococcal urethritis who presented to a sexually transmitted infection clinic in Indianapolis, Indiana. Urine and rectal swabs were collected and tested for urogenital and rectal CT, Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG). Men completed surveys concerning symptoms, sexual orientation, and detailed recent and lifetime oral and anal sexual behaviors. Results Rectal CT was detected in 2/84 (2.4{\%}) heterosexual men who reported cunnilingus, but no lifetime receptive anal behaviors. All of the men who denied receptive anal behaviors were negative for rectal NG and MG. In homosexual and bisexual men, rectal CT prevalence was high (9.7{\%}), and rectal NG (4.8{\%}) and MG (4.8{\%}) were also detected. Conclusions We detected rectal CT infections in heterosexual men who reported cunnilingus but denied receptive anal behaviors. Oral sex may be a risk factor for rectal CT infection via oral inoculation of the gastrointestinal tract.",
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