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Resolution of Symptoms and Resumption of Sex After Diagnosis of Nongonococcal Urethritis Among Men Who Have Sex With Men.
- Source :
-
Sexually transmitted diseases [Sex Transm Dis] 2019 Oct; Vol. 46 (10), pp. 676-682. - Publication Year :
- 2019
-
Abstract
- Background: Standard counseling at nongonococcal urethritis (NGU) diagnosis includes advice to abstain from sex for at least 7 days and until symptoms resolve.<br />Methods: From December 2014 to July 2018, we enrolled men who have sex with men and received azithromycin (1 g) for NGU at the Public Health-Seattle and King County STD Clinic. Over 12 weeks of follow-up, participants reported daily urethral symptoms and sexual activity on web-based diaries. Nongonococcal urethritis was defined as urethral symptoms or visible urethral discharge plus 5 or greater polymorphonuclear leukocytes per high-power field. Time of symptom resolution was defined as the first of 5 consecutive asymptomatic days.<br />Results: Of 100 participants with NGU and no Chlamydia trachomatis (CT)/Mycoplasma genitalium (MG) coinfection, 36 (36%), 22 (22%), and 42 (42%) had CT-NGU, MG-NGU, and non-CT/non-MG NGU, respectively. Among men with MG-NGU, 94% had a macrolide resistance mutation. For all etiologies, median time to symptom resolution after azithromycin was 7 days (95% confidence interval [CI], 5-9); 37% had symptoms lasting longer than 7 days. For men with CT-NGU, MG-NGU, and non-CT/non-MG NGU, median time to symptom resolution was 4 days (95% CI, 2-6; 16% >7 days), undefined days (95% CI, 7 to undefined; 60% >7 days), and 7 days (95% CI, 5-11; 46% >7 days), respectively. Median time to first sexual activity (any type) was 12 days (95% CI, 11-17); it was 16 days (95% CI, 12-18) to first urethral sexual exposure. Twenty-seven percent did not avoid urethral exposure for the recommended period.<br />Conclusions: Counseling at NGU diagnosis should educate patients that symptoms may persist more than 7 days, particularly for non-CT NGU, and emphasize the rationale for the 7-day abstinence period.
- Subjects :
- Adult
Anti-Bacterial Agents therapeutic use
Drug Resistance, Multiple
Follow-Up Studies
Humans
Longitudinal Studies
Male
Retrospective Studies
Sexual Abstinence
Treatment Outcome
Urethra immunology
Urethra pathology
Urethritis drug therapy
Washington
Homosexuality, Male statistics & numerical data
Sexual Behavior statistics & numerical data
Urethritis diagnosis
Urethritis etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1537-4521
- Volume :
- 46
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Sexually transmitted diseases
- Publication Type :
- Academic Journal
- Accession number :
- 31356530
- Full Text :
- https://doi.org/10.1097/OLQ.0000000000001040