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Detection of Gram-negative, intracellular diplococci in either the urethra or rectum was used for diagnosis of gonococcal infection.All patients with laboratory-diagnosed STIs were traced and treated.Participants were reimbursed KES 350 (approximately .70) per visit.Trained clinical officers identified anogenital warts by visual inspection of the external genitalia.Unfortunately, little is known about anogenital warts in such settings, despite the availability of 2 effective HPV vaccines (Gardasil and Gardasil-9) that protect against not only those HPV types that cause 90% of anogenital warts [8, 9].

Eligible individuals were invited to receive information about participation in research and alternatives for care, including several nonresearch HIV clinics in the study area.Syndromic STI treatment and antiretroviral therapy, when indicated, were provided in accordance with World Health Organization and Kenyan guidelines [12].Podophyllin was the only treatment available for warts.Visual inspection of the perianal area was also performed if the participant reported receptive anal sex or anorectal symptoms.Genital and perianal warts were recorded separately and included both verrucous and flat lesions.Men who reported any anal sex with another man within the last 3 months were classified as MSM.