Low Awareness of Mycoplasma genitalium in men who have sex with men (MSM) in Sydney, Australia.

OBJECTIVES Mycoplasma genitalium (M.genitalium) is a sexually transmitted infection of importance due to high prevalence rates and antimicrobial resistance (AMR) among men who have sex with men (MSM). METHODS A prospective cross-sectional analysis was carried out on MSM who presented rectally asymptomatic at a central Sydney sexual health clinic or a community site for routine testing. Between March and May 2017, participants were asked to complete a questionnaire prior to testing. We used multivariable logistic regression to identify factors associated with awareness and concern towards M.genitalium and AMR. RESULTS Overall 692/746 (92.5 %, 95%CI 90.7-94.5) MSM had no prior awareness of M.genitalium, 512/746 (68.6%, 95% CI 65.2-72.0) were not concerned or were neutral about the infection, 234/746 (31.4%, 95% CI: 28.0-34.8) were a little, somewhat, or very concerned. High partner numbers (AOR 4.2, 95% CI 2.1-8.2) and inconsistent condom users (AOR 3.1, 95% CI 1.2-8.2) and no condoms used (AOR 3.9, 95% CI 1.2-12.6) were associated with awareness of the infection. Time since arrival in Australia of more than 10 years (AOR 1.73, 95% CI 1.09-2.75), more than 12 months (AOR 1.91, 95%CI 1.31-2.79), and recreational drug use (AOR 1.95, 1.17-3.24) were associated with concern around having M.genitalium. Overall 61.6% (458/744 CI: 58.2-65.3) MSM reported that they would increase condom use (38.6% agreed and 23.1% strongly agreed) after reading about AMR. Among the remaining 38.4% (286/744), 28.4% indicated a neutral response to increasing their condom use. Relative to MSM born in Australia, Latin American (AOR 7.3, 95% CI 2.9-18.4) or Asian MSM (AOR 2.3, 95%CI 1.4-3.3), were significantly more likely to increase condom use after reading a statement on AMR. CONCLUSIONS Knowledge of M.genitalium remains low amongst MSM. Targeted messages using AMR and treatment difficulties with M.genitalium is unlikely to change behaviour for a large proportion of MSM.