Browsing by Author "Arno, Janet"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Detection of Rectal Chlamydia trachomatis in Heterosexual Men Who Report Cunnilingus
    (Wolters Kluwer, 2019-07-01) Batteiger, Teresa A.; Jordan, Stephen J.; Toh, Evelyn; Fortenberry, Lora; Williams, James A.; LaPradd, Michelle; Katz, Barry; Fortenberry, J. Dennis; Dodge, Brian; Arno, Janet; Batteiger, Byron E.; Nelson, David E.; Microbiology and Immunology, School of Medicine
    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 (NGU) 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. Summary. We observed a low incidence of rectal C. trachomatis infection in heterosexual men.
  • Thumbnail Image
    Item
    Sexually transmitted infections in association with area-level prostitution and drug-related arrests
    (Wolters Kluwer, 2020-12-15) Magee, Lauren A.; Fortenberry, J. Dennis; Nelson, Tammie; Roth, Alexis; Arno, Janet; Wiehe, Sarah E.; School of Public and Environmental Affairs
    Objectives: Examine the mediators and moderators of area-level prostitution arrests and sexually transmitted infections (STI) using population level data. Methods Using justice and public health STI/HIV data in Marion County (Indianapolis), Indiana, over an 18-year period, we assessed the overall association of area-level prostitution and drug-related arrests and STI /HIV, and mediators and moderators of the relationship. Point-level arrests were geocoded and aggregated by census block group. Results: Results indicate a positive relationship between numbers of prostitution arrests and area-level STI rates. There was a dose-response relationship between prostitution arrests and STI rates when accounting for drug-related arrests. The highest quintile block groups had significantly higher rates of reported chlamydia (IRR: 3.29, 95% CI: 2.82, 3.84), gonorrhea (IRR: 4.73, 95% CI: 3.90, 5.57), syphilis (IRR: 4.28, 95% CI: 3:47, 5.29), and HIV (IRR: 2.76, 95% CI: 2.24, 3.39) compared with the lowest quintile. When including drug arrests, the second (IRR: 1.19, 95% CI: 1.03, 1.38) and the third (IRR: 1.20, 95% CI: 1.02, 1.41) highest quintile block groups had lower IRR for reported rates of chlamydia, indicating that drug arrests mediated the prostitution arrest effect. Conclusions: These findings inform public health agencies and community-based organizations that conduct outreach in these areas to expand their efforts to include harm reduction and HIV/STI testing for both sex workers and individuals experiencing substance use disorder. Another implication of these data is the importance of greater collaboration in public health and policing efforts to address overlapping epidemics that engage both health and legal intervention.