A gengivite crônica e intratável observada em gatos infectados pelo vírus da imunodeficiência felina (FIV) é um problema bastante freqüente na clínica de pequenos animais. O papel do FIV na etiologia da estomatite persistente ainda está por ser determinado. As manifestações orais são freqüentemente os primeiros sintomas observados em pacientes humanos infectados pelo HIV e podem ser usadas como indicadores da progressão da doença. O objetivo do presente estudo foi quantificar os linfócitos T CD4+, T CD8+ e a razão CD4+/CD8+ em uma colônia de gatos com gengivite crônica e naturalmente infectados pelo FIV. Para tanto, foram utilizados 20 gatos, todos apresentando gengivite com graus variando de 1 a 4. Desse total, 10 gatos não eram infectados pelo FIV e os outros 10 felinos eram infectados pelo FIV. Utilizou-se como controle 20 gatos sem gengivite, sendo 10 infectados pelo FIV e outros 10 não infectados pelo Retrovírus. As contagens dos linfócitos T CD4+ e CD8+ foram realizadas utilizando-se a técnica de citometria de fluxo. Os resultados obtidos demonstraram que os gatos com gengivite e infectados pelo FIV apresentaram uma contagem significativamente menor de linfócitos T CD4+ quando comparado aos gatos com gengivite e não infectados pelo FIV. Não houve diferença significativa na contagem de linfócitos T CD8+ entre os gatos com gengivite, infectados ou não pelo FIV. A razão CD4+/CD8+ também se mostrou em declínio nos gatos com gengivite e infectados pelo FIV. Concluiu-se que nas condições do presente estudo, a infecção pelo FIV compromete a resposta imunológica de felino diante da inflamação gengival. / Chronic and intractable gingivitis in FIV-infected cats is a relatively common clinical problem in veterinary practice. The role of FIV in the etiology of persistent stomatitis is still undetermined. Oral manifestations often found in HIV-infected people are frequently the first clinical sign of the infection and can be considered as an indicator of the progression of the HIV infection. The purpose of this study was to evaluate the CD4+ and CD8+ T-lymphocytes count and CD4+:CD8+ ratio in a colony of cats with chronic gingivitis. To achieve these goals, a colony of twenty domestic shorthair cats was used. All cats had some degree of gingival inflammation with scores ranging from 1 through 4. Ten cats were FIV-positive and ten were FIV-negative. As a control, twenty cats without gingivitis were used (ten cats were FIV-positive and ten were FIV-negative). CD4+ and CD8+ T-lymphocytes counts were performed by means of flow cytometry in all forty cats and results compared. The results showed that cats with gingivitis and FIV-infected had a lower CD4+ T cells count than cats with gingivitis but not FIV-infected. There was no difference in CD8+ T lymphocytes count among the cats with gingivitis infected or not with the FIV. The CD4+:CD8+ ratio was lower in cats with gingivitis and FIV-infected. One can conclude that FIV infection induces immunological disorders in cats with gingival inflammation.

Os pacientes infectados pelo vírus da imunodeficiência humana (HIV) freqüentemente apresentam alterações digestivas, sendo o esôfago um alvo comum de lesões estruturais. A etiologia infecciosa é a mais freqüente neste grupo de pacientes. Múltiplos agentes já foram implicados como causadores de lesões esofágicas. As infecções virais são uma das principais causas de tais lesões, sendo os vírus mais implicados o citomegalovirus (CMV) e o vírus herpes simples (HSV). Muitas lesões ulceradas permanecem sem diagnóstico etiológico, mesmo após exaustiva investigação, sendo denominadas úlceras idiopáticas ou aftosas. Os métodos de diagnóstico usuais são demorados e pouco sensíveis. Assim, nosso estudo tem como principal objetivo estudar o papel do método da reação em cadeia da polimerase (PCR) no diagnóstico destas lesões. Durante o período de outubro de 1996 a outubro de 1997, foram estudados 79 pacientes HIV-positivos, que foram submetidos ao exame de endoscopia digestiva alta por indicação clínica. Estes foram submetidos a 89 exames endoscópicos, sendo colhidas 96 biópsias, as quais foram armazenadas em nitrogênio líquido (50) ou em freezer a –70oC (46). O DNA foi extraído usando método baseado na lise hipotônica, digestão com proteinase K, extração com fenol-clorofórmio e precipitação em etanol. Uma quantidade fixa foi usada para amplificação em ciclador térmico, utilizando primers específicos para CMV, Herpesvirus, HPV, HIV, Haemophilus ducreyi, Treponema pallidum e as micobactérias M. tuberculosis, M. avium e M. intracellulare. O produto final foi submetido a uma eletroforese em gel de agarose e corado com brometo de etídeo. A endoscopia não revelou alterações esofágicas em 26 exames (29,2%). As alterações observadas foram monilíase esofágica em 33 exames (37,1%), úlceras em 22 (24,7%); esofagite em 10 (11,2%) e áreas lugol-negativas em 9 (10,1%). A PCR resultou positiva para o CMV em 19 amostras (19,8%), para o Herpes em 4 (4,2%), para o HPV em 17 (17,7%), para o HIV em 37 (38,5%) e para o H. ducreyi em 3 (3,1%). Nenhuma amostra foi positiva para o T. pallidum e para micobactérias. No estudo de 29 amostras de 22 úlceras esofágicas a PCR detectou o CMV em 9 amostras (31%), o Herpes em 3 (10,3%), o HPV em 6 (20,7%), o HIV em 19 (65,5%) e o H. ducreyi em 2 (6,9%) e em 8 (36,4%) não foi detectado nenhum agente. O CMV foi detectado com freqüência nas úlceras esofágicas, sendo difícil diferenciar se havia infecção ativa ou latente. O HIV teve uma incidência elevada nas biópsias de úlceras, o que pode sugerir um possível papel etiológico deste agente em tais lesões. O HPV foi o terceiro agente mais freqüente, mas não foi possível caracterizá-lo como causador de lesões esofágica ulceradas. A PCR apresentou potencial para tornar-se um método útil na investigação das lesões esofágicas em pacientes infectados pelo HIV. / Patients infected by Human Immunodeficiency Virus (HIV) usually present digestive abnormalities and the esophagus is a common target of structural lesions. Infections are the most frequent cause of esophageal lesions in these patients. Several agents were already implied in this process. Viral infections are one of the main causes of such lesions and cytomegalovirus (CMV) and herpes simplex virus (HSV) were the most involved agents. Many ulcerated lesions persist without etiologic diagnosis even after exhaustive investigation, being denominated idiopathic or aphthous ulcers. The usual diagnostic methods are difficult and have low sensitivity. Thus, the main objective of our study was to evaluate the role of the polimerase chain reaction (PCR) method in the diagnosis of these lesions. During the period of October of 1996 to October of 1997, 79 HIV-positive patients were studied. They were submitted to upper digestive endoscopies, which were indicated on clinical basis. These patients were submitted to 89 upper digestive endoscopies, being obtained 96 biopsies, which were stored in liquid nitrogen or in a 70oC freezer. DNA was extracted using a method based on hypotonic lyses, proteinase K digestion, extraction with phenol-chloroform and precipitation in ethanol. A fixed amount was used for amplification in thermal cycler, using specific primers for CMV, herpesvirus, human papillomavirus (HPV), HIV, Haemophilus ducreyi, Treponema pallidum, Mycobacterium tuberculosis, Mycobacterium avium and Mycobacterium intracellulare. The final products were submitted to an electrophoresis in agarose gel and stained with ethidium bromide. The endoscopies did not reveal esophageal alterations in 26 exams(29,2%). The abnormalities observed were esophageal candidiasis in 33 exams (37,1%), ulcers in 22 (24,7%); esophagitis in 10 (11,2%) and lugol-negative areas in 9 (10,1%). The PCR was positive to CMV in 19 samples (19,8%), for Herpes in 4 (4,2%), for HPV in 17 (17,7%), for HIV in 37 (38,5%) and for the H. ducreyi in 3 (3,1%). No sample was positive for T. pallidum or micobacterium. In the study of the esophageal ulcers by PCR, CMV was detected in 9 samples (31%), Herpes in 3 (10,3%), HPV in 6 (20,7%), HIV in 19 (65,5%), H. ducreyi in 2 (6,9%) and any agent was detected in 8 samples (36,4%). CMV was frequently detected in esophageal ulcers, being difficult to differentiate between active and latent infections. The HIV had an elevated incidence in ulcer biopsies, which may suggest a possible etiologic role of this virus in such lesions. HPV was the third more frequent agent, but it was not possible to attribute the esophageal lesions to that virus. In conclusion, this study suggests that the PCR can be an useful method in the investigation of esophageal lesions in HIV infected patients.

Na rotina de felinos domésticos, algumas modalidades de diagnóstico por imagem, como a radiografia simples e, na última década, a tomografia computadorizada (TC) já são amplamente utilizadas. Este estudo teve por objetivo realizar uma análise crítica da contribuição dos exames radiográfico e tomográfico (simples e contrastado), na avaliação do trato respiratório de felinos portadores ou não de imunodeficiência viral (FIV). Identificando as principais alterações encontradas em felinos FIV+ aos exames radiográfico e tomográfico do crânio e tórax. E ainda, correlacionando os achados radiográficos e tomográficos com os resultados laboratoriais de sorologia para imunodeficiência viral felina, citologia e cultura (bacteriana e fúngica) do lavado traqueal. Foram utilizados 20 felinos adultos jovens de ambos os sexos, sendo 14 FIV+ e 06 FIV-, todos provenientes do mesmo gatil. Pela análise estatística houve um maior percentual de felinos FIV+ com opacificação nas bulas timpânicas pela TC (57,14%) e resultado positivo na análise citológica do lavado traqueal (85,71%). Constatou-se que os felinos portadores de imunodeficiência viral possuíram, por meio da avaliação radiográfica e tomográfica, um maior comprometimento do trato respiratório relacionado às cavidades nasais, bulas timpânicas, parênquima pulmonar e vias aéreas inferiores, quando comparados aos felinos negativos para imunodeficiência viral. / In internal medicine of domestic cats, imaging modalities, such as radiography and, in the last decade, computed tomography (CT) are widely used. The aim of this study was to perform a critical analysis of the radiographic and tomographic contribution in assessing the respiratory tract of feline immunodeficiency vírus (FIV) infected cats and FIV negative cats. Identifying the radiographic and tomographic findings, in FIV+ cats, of the skull and chest examination. And, correlating radiographic and tomographic findings with the laboratory serology for feine immunodeficiency vírus results, cytology evaluation and culture (bacterial and fungal) from tracheal lavage fluid.Twenty young adults cats of both gender were used, 14 FIV+ and 06 FIV-, all from the same cattery. By the statstical analysis there was a higher percentage of FIV+ infected cats with timpanic bullae opacification by the CT examination (57,14%) and positive cytologic evaluation of traqueal aspirates (85,71%). It was found that FIV+ infected cats has greater involvement of the respiratory tract related to the nasal cavity, tympanic bullae, lung parenchyma and lower airways, when compared with FIV- cats.

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2018-08-24T19:19:55Z No. of bitstreams: 1 2016 - Marli Sidoni.pdf: 1735106 bytes, checksum: 03907fc3437a44bf96b94d6040184407 (MD5) / Made available in DSpace on 2018-08-24T19:19:55Z (GMT). No. of bitstreams: 1 2016 - Marli Sidoni.pdf: 1735106 bytes, checksum: 03907fc3437a44bf96b94d6040184407 (MD5) Previous issue date: 2016-12-01 / This work focused on deploying IgY technology into developing ELISA immunoenzymatic test to FIV diagnose, contributing to the establishment of a production model for a kit in the field of veterinary medicine. The first stage of this work consisted in analyzing the literature of the veterinary documents aimed to diagnose animal diseases, as stated in our current legislation. The access to both national and international optimized the enlightenment of developing parameters and method validation criteria for the development of this new product, named ELISA r-p24 IgY. The second stage consisted in establishing purification production and physicochemical characterization of the recombinant protein p24 of FIV. The biological activity maintenance was proved by way of Western Blot test with the banda presence of approximately 25 kDa, referring to the p24 protein. The third stage was to obtain IgY cat anti-IgG, derived from hens inoculation. The kinetics were monitored by ELISA and the outcome demonstrated that as of the second week, there was a gradual increase in antibody in the yolk, and remained high throughout the period of five months. Reference to the chicken 1, the average concentration was 40,1 mg/mL e for the chicken 2 was 32,2 mg/mL, throughout the period of 5 months. The fourth stage was the use of IgY technology to develop, standardize e validate the r-p24 IgY ELISA related to its use to diagnose the infection caused by FIV. The results were: 99% accuracy, 97.7% sensitivity, 99.5% specificity and 99.1% kappa index. In the fifth stage was carried out a comparative study between ELISA r-p24 IgY and ELISA r-p24 IgG, and it was demonstrated superior performance of the ELISA r-p24 IgY. The ELISA r-p24 IgY to have favorable characteristics from a commercial perspective, such as high precision and maintenance of reactivity for a minimum period of 12 months. Therefore, the above described procedure was efficient and enabled the development of a FIV test. The predominance of IgY technology may contribute to research and development of new tests, following both international regulation related to animal welfare and validation, thus boosting national development of diagnostic kits, for the benefit of human health or animal. / O objetivo deste trabalho foi aplicar a tecnologia IgY no desenvolvimento de um teste imunoenzim?tico, ELISA, para o diagn?stico do FIV, contribuindo no estabelecimento de um modelo de produ??o para um kit nacional na ?rea de medicina veterin?ria. A primeira etapa do desenvolvimento deste trabalho consistiu na revis?o da literatura dos documentos pr?prios para produtos de uso veterin?rio, destinados a diagnosticar doen?as dos animais, disponibilizados na legisla??o vigente. A consulta aos documentos nacionais e internacionais potencializou o esclarecimento de par?metros de desempenho ou crit?rios de valida??o de m?todos, para o desenvolvimento deste novo produto, denominado ELISA r-p24 IgY. A segunda etapa consistiu no estabelecimento da produ??o, purifica??o e caracteriza??o f?sico-qu?mica da prote?na recombinante p24 do FIV. A preserva??o da atividade biol?gica foi demonstrada por Western Blot com a presen?a de uma banda pept?dica de aproximadamente 25 kDa, referente ? prote?na r-p24. A terceira etapa deste trabalho, consistiu na obten??o de anticorpos IgY anti-IgG de gato, a partir da inocula??o em galinhas poedeiras. A cin?tica foi acompanhada por ELISA demonstrando um aumento gradativo do t?tulo de anticorpos na gema a partir da segunda semana, com um aumento significativo no 2? m?s, e mantendo-se elevado durante todo o per?odo de cinco meses. As concentra??es m?dias de prote?nas na galinha 1 foi de 40,1 mg/mL a partir de uma gema e na galinha 2 foi de 32,2 mg/mL por gema, no per?odo de 5 meses. A quarta etapa deste trabalho consistiu no emprego da tecnologia IgY para o desenvolvimento, padroniza??o e a valida??o do teste de Elisa r-p24 IgY para o diagn?stico da infec??o causada pelo FIV. Os resultados obtidos foram: a acur?cia de 99%, a sensibilidade de 97,7%, a especificidade de 99,5%, e o ?ndice kappa de 99,1%. Na quinta etapa deste trabalho realizou-se o estudo comparativo do ELISA r-p24 IgY frente ao ELISA r-p24 IgG, e foi demonstrado o desempenho superior no ELISA r-p24 IgY. A valida??o do ELISA r-p24 IgY mostrou caracter?sticas desej?veis para o uso comercial, tais como alta precis?o e manuten??o da reatividade por um per?odo m?nimo de 12 meses. Conclui-se que o procedimento elaborado foi eficiente e possibilitou o desenvolvimento de um teste para o diagn?stico do FIV. O dom?nio da Tecnologia IgY poder? contribuir com a pesquisa e o desenvolvimento de novos ensaios atendendo ?s normas e diretrizes nacionais e internacionais, tanto de bem-estar animal como de valida??o, impulsionando o desenvolvimento nacional de kits diagn?sticos de interesse em sa?de humana ou animal.

Abstract Background: 36,9 millions of people are today living with the Human immunodeficiency virus (HIV). Every year 400-500 new cases of HIV occur and today approximately 6,500 people live with the disease in Sweden. Getting a chronic disease can mean a changed life situation for the affected person and the society tends to stigmatize people living with HIV. Purpose: To describe people's experiences of living with HIV. Method: A literature study with descriptive design was produced and 12 scientific qualitative articles from the database CINAHL were included in the content of the study. Findings: Four main themes were identified for the study's findings: Getting the diagnosis of HIV, Relationships, Difficulties and Negative Emotions, and Changed Perspectives and Positive Emotions. Some participants in the study experienced difficulties living with HIV. In connection with newly discovered HIV diagnosis, many feelings and reactions could arise. Lost hopes, guilt and shame were common experiences of people living with HIV. Fear existed over how family, friends and society would look at them differently. Some people experienced a negative response from healthcare professionals, while some found healthcare professionals as an important support. Some people initially felt feelings of hopelessness and looked at their illness as a death sentence, but over time they got a changed perspective with increased understanding and could instead see bright on the future. Conclusion: Different experiences emerged from living with HIV. Getting the diagnosis of HIV could create devastating feelings for the affected person, but through different kinds of support and strategies, people could have a more positive view of life. Experiences of being treated differently in health care and from their environment could be a great strain in their daily life. In the nurse's work it is therefore important to provide people with HIV as well as relatives with adequate information about the disease and work for person-centered care.

Human immunodeficiency virus type 1 (HIV-1) establishes a persistent infection that leads to acquired immunodeficiency syndrome (AIDS). Approximately 36 million people worldwide are living with HIV-1, which is commonly acquired through sexual contact. Antiviral therapies control disease progression, but do not eliminate this virus from the host. Thus, global efforts are focused on developing vaccines that prevent HIV-1 transmission. Such vaccines are based on eliciting the production of protective antibodies that target the envelope glycoproteins (Envs) of this virus. Unfortunately, HIV-1 immunization trials have shown limited efficacy. A better understanding of the antibody-mediated inactivation process is needed to improve vaccine strategies. In this work we describe two novel factors that contribute to HIV-1 inactivation. First, we show that structural stability of the Env protein determines its sensitivity to vaccine-elicited antibodies. Different interactions within Env contribute to its stability. Perturbation of the Env-stabilizing interactions by physical and chemical treatments enhances sensitivity of HIV-1 to antibodies. Second, we found that the chemical composition of the transmission medium affects Env inhibition by antibodies and other inhibitory agents. Semen is the most common vehicle for HIV-1 transmission. This medium contains high concentrations of the sugar fructose. We found that semen fructose competitively blocks binding of antiviral agents that target sugar residues on Env. Together, this work advances our understanding of the mechanism that underlies HIV-1 inactivation by vaccine-elicited antibodies and provides novel strategies to enhance their potency.

Older adults with infectious and chronic diseases, such as cardiovascular disease and human immunodeficiency virus (HIV), are at high risk for associated chronic comorbidities, which are associated with increased medical expenditures to cover treatment costs. The purpose of this study was to investigate (a) whether adults 65 or older with either HIV or cardiovascular disease were predisposed to increased medical expenditures versus adults 64 and younger, and (b) the impact of race and type of health service used on total direct medical expenditures incurred among adults with HIV or cardiovascular disease. A quantitative, deductive, retrospective cross-sectional design was used, and the behavioral model of health services use and the socioecological model were chosen as the study’s theoretical foundations. Analyses were conducted using binary logistic regression. Controlling for confounding variables of education and region of residence, the key findings were that adults ≥ 65 years had higher odds of incurring higher expenditures overall. White patients had higher odds of incurring higher expenditures for medication (OR 1.251), office-based visits (OR 1.433), inpatient visits (OR 1.245), and outpatient visits (OR 1.451) when compared to other races. Older adults with HIV had higher expenditures for medication and home health (OR 1.850); and older adults with cardiovascular disease had higher outpatient (OR 1.235), inpatient (OR 2.142), and emergency room expenditures (OR 1.063). These findings might promote social change because assessing the influences of cost disparities on infectious and chronic diseases can help address variations in health care costs and can initiate the development of tailored evidence-based practice guidelines that can help older adults.

Thesis (M.Sc. (Pharmacology)) --University of Limpopo, 2014 / Consult the document

Stigma and discrimination are now recognised as major factors in the spread of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS). To date, research has focused on how to change individual responses to stigma and discrimination without exploring the social and structural dimensions. Complex community and societal dimensions, such as culture, power and difference need to be explored if progress is to be made in coping with stigma and discrimination. India now has HIV/AIDS prevalence figures to rival sub Saharan Africa. The disease has spread from high-risk populations such as intravenous drug users and commercial sex workers into the general population. Married, monogamous, heterosexual women in slum communities are highly vulnerable. Factors such as caste, class, ethnic group, poverty and social expectations present formidable layers of stigma for these women. They have also faced discrimination since before their birth. HIV/AIDS imposes yet another layer of stigma and discrimination upon their shoulders. The aims of the study were firstly to investigate whether stigma and discrimination existed for these women by documenting and analysing literature on the individual, societal and cultural situation of Indian women living with HIV/AIDS (IWLWHAs). Secondly, the study aimed to identify, evaluate and explore the psychosocial needs and coping strategies of IWLWHAs, to determine the barriers to accessing health services, and describe community perceptions as they were experienced by the participants. / This qualitative research study examined the multiple layers of stigma and discrimination experienced by women infected and affected by HIV/AIDS in a low socio-economic area of Mumbai, India. This was achieved by interviewing women who were benefiting from a home-based service - Positive Living - An integrated home-based care programme for people living with HIV/AIDS under the auspices of the KJ Somaiya Hospital in Mumbai. This programme provides a nutrition and home-based service to the nearby community slums. The conceptual framework used for this study was developed to evaluate the effects of natural disasters such as tsunamis, floods and earthquakes. HIV/AIDS is no less of a tragedy for individuals, families and communities. Within this framework, human capacity or the ability of individuals to cope is linked to social ecology - the relationship between individuals and their community. This dimension overlaps with culture and values. Three other dimensions affect humans - economic status, the environment and living conditions, and physical health. I have developed this framework further to examine threats and strengths which arise from these dimensions, and which affect human resilience. An exploratory case study was considered the most suitable approach to explore these areas, as it permits more sensitivity and richer data, and enhances rigour. In-depth interviews of 45 women in three different age groups, home visits and observations, focus group discussion, key informants, narratives, vignettes and photographs were supported by documentary data collection in triangulation of the data. A reflective journal recorded observations and perceptions in the field during three months in India. / Results from the combined data indicated that IWLWHAs experienced discrimination in their families, communities and health care settings. Fear of future discrimination ensured secrecy which, in turn, prevented them accessing community services which would provide emotional and physical support. A range of reactions was demonstrated by the affected women, half of whom were also infected which added to their burden. Women who could not disclose their condition were extremely isolated, lacked family and community support, feared the future and felt hopeless. Despite their appalling living conditions of poverty, overcrowding, prevalence of disease and pollution, the women displayed a sense of pride, dignity and resilience. Culturally appropriate strategies are necessary to address the lack of education and awareness as only two of the 45 women had any knowledge of HIV/AIDS before their own diagnosis which often followed their husbands' positive status. In addition, the social and cultural dimensions which affect these women have to be explored and examined in order to strengthen the 'shock absorbers' of the family. The community health workers and co-ordinator of the home-based service were vital in providing emotional support and health information to the women. Finally, no change is possible unless men take responsibility for their sexual mores. Policy makers and programmes have to look further for strategies which would engage men in the process to change their attitudes and thus protect vulnerable women and children.

This thesis presents data on two separate areas relevant to the prevention of HIV and sexually transmitted infection (STI) transmission in homosexual men. These data arise from the community-based Health in Men (HIM) cohort of HIV-negative homosexual men in Sydney. First, the association of circumcision status with HIV and STIs was examined. Older age, ethnicity and country of birth were demographic factors independently associated with circumcision status. Self-report was a valid measure of circumcision status in this population. Overall, being circumcised was associated with a non-significant reduced risk of HIV seroconversion in the HIM cohort (HR 0.76, 95% CI 0.41-1.41, p=0.381). Among the one-third of participants predominantly practising the insertive role in anal intercourse (AI), being circumcised was associated with a significantly reduced risk of HIV infection (HR 0.15, 95% CI 0.03-0.80, p=0.026). Circumcised HIM participants also had a lower risk of incident syphilis (HR 0.35, 95% CI 0.15-0.84, p=0.019), however circumcision status had no significant effect on the remainder of prevalent and incident STIs examined. Second, risk factors for pharyngeal gonorrhoea and chlamydia were investigated. The BD ProbeTec nucleic acid amplification test (NAAT) had a positive predictive value (PPV) for pharyngeal gonorrhoea diagnosis of only 30.4% (95% CI 25.2-36.1%) when compared to a previously validated NAAT targeting the gonococcal porA pseudogene. Pharyngeal gonorrhoea was common in HIM, mostly occurred without concurrent anogenital infection and may frequently spontaneously resolve. Infection was independently associated with younger age (p-trend=0.001), higher number of male partners (p-trend=0.002), contact with gonorrhoea (p<0.001) and insertive oro-anal sex with casual partners (p-trend=0.044). Pharyngeal chlamydia was less common but a high prevalence/incidence ratio suggested that infection may persist in the pharynx for long periods. Pharyngeal chlamydia was independently associated with receptive penile-oral sex with casual partners (p-trend=0.009). In conclusion, circumcision may have a role as an HIV prevention intervention among the subgroup of homosexual men who predominantly practise insertive rather than receptive AI. Regular screening of the pharynx including a validated supplemental NAAT for gonorrhoea diagnosis may prevent much transmission to anogenital sites, whereas chlamydia occurs too infrequently in the pharynx to recommend routine screening in homosexual men.