Prevalence, Duration, and Severity of Rectal Symptoms Among Men Who Have Sex With Men With Rectal Sexually Transmitted Infections.

Background: Rectal sexually transmitted infections (STIs) are commonly diagnosed among men who have sex with men (MSM), but limited prospective data exist on the rectal symptomatology associated with these infections. Method: In 2016-2018, we enrolled 140 MSM in a 48-week cohort study in Seattle, Washington. Participants self-collected weekly rectal specimens that were tested at the end of the study for Results: Participants reported rectal symptoms during 12 (38%) of 32 incident rectal CT infections, 6 (30%) of 20 incident rectal GC infections, and 9 (60%) of 15 incident rectal MG infections. Rectal symptoms were significantly more likely to be reported during weeks when participants tested positive for CT, GC, or MG (8.1% [44/544]) compared to weeks when specimens tested negative for all 3 (3.9% [97/2456]) (aRR = 3.01; 95% CI = 1.77-5.13). Rectal itching was the most common symptom during weeks when participants tested either positive (4.6%) or negative (1.7%); rectal discharge was rare (<1% of weeks). The median duration of symptoms was 1 week for CT and GC and 3 weeks for MG. Conclusions: Rectal symptoms are common among persons with rectal GC, CT, and MG infections but are typically mild and of short duration.