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In particular, determining who is ‘at risk’ can be difficult for healthcare providers to assess. Though the CDC recommends testing every 3–6 months for ‘at-risk’ MSM, reliance on this directive for determining testing may also contribute to testing disparities. 4 Moreover, efforts to address the need for rectal STI testing have not been prioritised, 5 with the first Food and Drug Administration-approved rectal STI diagnostic test not appearing until 2019. 4 In prior research, providers ranged from two (18.3% urethral vs 8.5% rectal) to six times (13.8% urethral vs 2.3% rectal) more likely to perform urethral chlamydia and gonorrhoea screening as compared with rectal screening. However, rectal STI screening is less frequently performed than urethral screening among MSM in community-based sexual health clinics (for both individuals living and not living with HIV in the USA). 2 As such, the Centers for Disease Control and Prevention (CDC) recommends 3 routine testing for STIs at each site of sexual contact every 3–6 months for sexually active MSM. 1 STIs remain a strong predictor of HIV seroconversion.
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Without changes in current HIV incidence rates, it is estimated that 60% of BGBMSM will be living with HIV by the age of 40 years. Despite advancements in HIV prevention, Black gay, bisexual and other men who have sex with men (BGBMSM) continue to experience a high burden of HIV in the USA.