Sexually transmitted infections (STI) represent a high global burden in mortality and morbidity. Evidence from a number of countries suggests worrisome increases of STI among men who have sex with men (MSM). Sex between men remains the predominant mode of HIV transmission in the western EU/EEA region.
In order to identify risk factors for STI transmission among MSM in Norway, we conducted a large cross-sectional online study on Gaysir website in 2007. For trends, we analysed data on gonorrhoea, syphilis and HIV from The Norwegian Surveillance System for Communicable Diseases (MSIS) from 1992-2013.
We observed worrisome increases in the incidence of reported gonorrhoea, syphilis and HIV among Norwegian MSM. Of particular concern is an observed increase in concurrent infections of HIV and either syphilis or gonorrhoea, as STI can facilitate the transmission of HIV. Majority of MSM have been infected in Oslo municipality.
Data from the online sample of MSM (N=2430) suggested the following STI risk factors: a high number of sexual partners, having unsafe sex under the influence of alcohol or selected drugs as well as certain demographic factors.
We identified a high sexual partners’ turnover and frequent concurrent sexual relationships with women among study participants. Important proportion of MSM (23.7%) in the study reported unprotected anal intercourse (UAI) with a casual or anonymous partner in the last 6 months. Many study participants admitted not revealing their sexual practices to their dedicated physician, which can affect early detection of STI. While knowledge of the risk of HIV transmission with UAI was good, awareness of current increasing STI trends in Norway was poor.
Important gaps in STI surveillance and knowledge of STI transmission among MSM in Norway have been identified. Effective interventions to prevent STI spread among MSM and scaled up efforts for early detection and effective treatment of these infections are urgently needed.