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Guarino P, Chiari F, Carosi C, Parruti G, Caporale CD, Presutti L, Molteni G. Description of clinical cases and available diagnostic tools of oropharyngeal syphilis: a systematic review of the literature. BMC Infect Dis 2024; 24:1252. [PMID: 39506662 PMCID: PMC11539797 DOI: 10.1186/s12879-024-10129-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 10/28/2024] [Indexed: 11/08/2024] Open
Abstract
INTRODUCTION Syphilis is a systemic bacterial infection caused by the spirochete Treponema pallidum. Head and neck mucosal manifestations of syphilis can be observed in each and all of primary, secondary and tertiary syphilis, especially in the secondary one. Therefore, oropharynx is an unusual localization of syphilitic lesions, mainly represented by ulcerous lesions, tissue hypertrophy, mucosal patches and cancer-like lesions. Serology is routinely considered the gold standard for the screening and diagnosis of syphilis. However, direct detection is routinely used during polymerase chain reaction (PCR) of oropharyngeal tissue and suspicious cervical lymphadenopathies. METHODS PRISMA 2020 guidelines were applied to make a systematic literature review with the aim to make an overview of clinical manifestations and diagnostic tools of oropharyngeal syphilitic infection. A computerized MEDLINE search was performed using the PubMed, Web of Science and Cochrane databases. RESULTS The intended analysis was based on 38 papers, including a total of 55 cases. The main localization of oropharyngeal infection was the tonsil (71%), followed by lateral and posterior wall of oropharynx (16%). Ulcerous lesions were the most frequently encountered lesions in the primary syphilis (56%) and secondary syphilis (36%), whereas gumma's lesions were encountered in the tertiary syphilis (57%). Diagnosis based on serological assays was used in combination with non-treponemal methods to determine disease activity (80% cases). CONCLUSIONS Oropharyngeal syphilis has historically been referred to as the "great imitator" due to its highly variable manifestations, which can resemble malignancies. Physicians have to recognize oropharyngeal luetic features early, in order to set up an effective diagnostic and therapeutic work-up.
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Affiliation(s)
- Pierre Guarino
- Otolaryngology Head and Neck Unit - "Santo Spirito" Hospital, Pescara, Italy
| | - Francesco Chiari
- Otolaryngology and Audiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - Carlo Carosi
- Otolaryngology and Audiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giustino Parruti
- Infectious Diseases Unit - "Santo Spirito" Hospital, Pescara, Italy
| | | | - Livio Presutti
- Otolaryngology and Audiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Gabriele Molteni
- Otolaryngology and Audiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Pravosud V, Ballard AM, Holloway IW, Young AM. Latent Class Analysis of Online Platforms for Partner-Seeking and Sexual Behaviors Among Men Who Have Sex with Men from Central Kentucky. AIDS Behav 2024; 28:1015-1028. [PMID: 37824036 PMCID: PMC11864497 DOI: 10.1007/s10461-023-04210-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
Little is known whether engagement in sexual behaviors associated with potential HIV risks differs by subgroups of men who have sex with men (MSM), who are distinct regarding patterns of use of online tools for partner-seeking. Using latent class analysis, we revealed four classes of app-using MSM (n = 181, 18-34 y.o., 82.4% identified as White and non-Hispanic) residing in Central Kentucky: the Grindr/Tinder class; the Poly App Use class of MSM-oriented apps; the General Social Media class, and the Bumble class. Unadjusted penalized logistic regressions showed associations of the Poly App Use class with increased numbers of receptive anal sex partners and reporting condomless receptive anal sex. Adjusting for other covariates, poly app users versus others were more likely to be older (25-34 vs. 18-24, AOR = 3.81, 95%CI = 1.70-9.03), to report past six-month illicit drug use (AOR = 2.93, 95%CI = 1.25-7.43) and to have ever used pre-exposure prophylaxis (AOR = 2.79, 95%CI = 1.10-7.12). Poly app users had behavior profiles associated with an elevated HIV risk and also reported HIV-related protective behaviors likely indicating increased risk awareness among this class. Our findings warrant differentiation of behavior profiles by patterns of app use and suggest not to generalize sexual behaviors associated with potential HIV risks to all app-using MSM.
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Affiliation(s)
- Vira Pravosud
- Northern California Institute for Research and Education, University of California San Francisco, San Francisco VA Medical Center, San Francisco, CA, USA.
| | - April M Ballard
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Ian W Holloway
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA, USA
| | - April M Young
- Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington, KY, USA
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
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King CMB, Garfein RS, Bazzi AR, Little SJ, Skaathun B. Association between where men who have sex with men (MSM) meet sexual partners and chlamydia/gonorrhoea infection before and during the COVID-19 pandemic in San Diego, California. Sex Transm Infect 2023; 99:527-533. [PMID: 37402567 PMCID: PMC10764637 DOI: 10.1136/sextrans-2022-055591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 06/18/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Meeting sex partners online is associated with increased risk of acquiring sexually transmitted infections. We examined whether different venues where men who have sex with men (MSM) meet sex partners was associated with prevalent Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection, and whether prevalence increased during (vs before) the COVID-19 pandemic. METHODS We conducted a cross-sectional analysis of data from San Diego's 'Good To Go' sexual health clinic from two enrolment periods: (1) March-September 2019 (pre-COVID-19) and (2) March-September 2021 (during COVID-19). Participants completed self-administered intake assessments. This analysis included males aged ≥18 years self-reporting sex with males within 3 months before enrolment. Participants were categorised as (1) meeting new sex partners in-person only (eg, bars, clubs), (2) meeting new sex partners online (eg, applications, websites) or (3) having sex only with existing partners. We used multivariable logistic regression, adjusting for year, age, race, ethnicity, number of sex partners, pre-exposure prophylaxis use and drug use to examine whether venue or enrolment period were associated with CT/NG infection (either vs none). RESULTS Among 2546 participants, mean age was 35.5 (range: 18-79) years, 27.9% were non-white and 37.0% were Hispanic. Overall, CT/NG prevalence was 14.8% and was higher during COVID-19 vs pre-COVID-19 (17.0% vs 13.3%). Participants met sex partners online (56.9%), in-person (16.9%) or only had existing partners (26.2%) in the past 3 months. Compared with having only existing sex partners, meeting partners online was associated with higher CT/NG prevalence (adjusted OR (aOR) 2.32; 95% CI 1.51 to 3.65), while meeting partners in-person was not associated with CT/NG prevalence (aOR 1.59; 95% CI 0.87 to 2.89). Enrolment during COVID-19 was associated with higher CT/NG prevalence compared with pre-COVID-19 (aOR 1.42; 95% CI 1.13 to 1.79). CONCLUSIONS CT/NG prevalence appeared to increase among MSM during COVID-19, and meeting sex partners online was associated with higher prevalence.
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Affiliation(s)
- Colin M B King
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Richard S Garfein
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Angela R Bazzi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Susan J Little
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Britt Skaathun
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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Begovac J, Romih Pintar V, Vrsaljko N, Močibob L, Bogdanić N, Zekan Š, Đaković Rode O. Incidence, risk factors, and clinical findings of syphilis among men living with HIV in Croatia during the COVID-19 pandemic. Sci Rep 2023; 13:11784. [PMID: 37479770 PMCID: PMC10361976 DOI: 10.1038/s41598-023-38807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023] Open
Abstract
We conducted a nationwide longitudinal observational study to estimate the incidence of syphilis in a cohort of male persons living with HIV (MLWH) in Croatia in the pre-COVID-19 and COVID-19 years. Data were reviewed and extracted from the clinical database. We analyzed 1187 MLWH (≥ 18 years) in care in Croatia from 2018 to 2021 and used Poisson regression to calculate rates. We observed a 91.4% increase in incidence between 2019 and 2020; the overall rate was 6.0/100 person-years, and the annual rate ranged from 3.3/100 person-years in 2018 to 9.3/100 person-years in 2021. We found higher rates in men who have sex with men, MLWH with a baseline history of syphilis, MLWH with a more recent HIV diagnosis, and a lower rate in those who had clinical AIDS. The rate of syphilis serological testing was 3.5% lower in 2020 compared to 2019. Recurrent syphilis was more likely asymptomatic compared to the first episodes. In conclusion, during the COVID-19 epidemic years, there was a huge increase in syphilis. Results highlight the need for enhanced and novel prevention interventions.
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Affiliation(s)
- Josip Begovac
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Vanja Romih Pintar
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Nina Vrsaljko
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Loris Močibob
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Nikolina Bogdanić
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Šime Zekan
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Oktavija Đaković Rode
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Orbe-Orihuela YC, Sánchez-Alemán MÁ, Hernández-Pliego A, Medina-García CV, Vergara-Ortega DN. Syphilis as Re-Emerging Disease, Antibiotic Resistance, and Vulnerable Population: Global Systematic Review and Meta-Analysis. Pathogens 2022; 11:1546. [PMID: 36558880 PMCID: PMC9785152 DOI: 10.3390/pathogens11121546] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
Syphilis is a sexually transmitted disease that has become a public health problem, especially in vulnerable populations. A systematic review and time-free meta-analysis of the publications on the molecular detection of syphilis and mutations associated with antibiotic resistance, CORE group, and syphilis genotypes in PubMed databases, Scielo, and Cochrane was performed, and the last search was conducted in June 2022. Proportions were calculated, and standard errors and confidence intervals were reported for all results of interest. We included 41 articles for quantitative extraction and data synthesis. An increase was observed in the proportion of subjects diagnosed with syphilis and the presence of the A2058G mutation during the 2018−2021 period compared to 2006 (70% 95%CI 50−87 vs. 58% 95%CI 12−78), and we observed that the greater the proportion of the population participating in men who have sex with men (MSM) (<50% and >50%) syphilis increased (78% 95%CI 65−90 vs. 33% 95%CI 19−49). In conclusion, we suggest that there are a set of characteristics that are contributing to the resurgence of syphilis and the selective pressure of bacteria. The MSM population could be a vulnerable factor for this scenario and the global presence of A2058G and A2059G mutations that confer resistance to macrolides.
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Affiliation(s)
| | | | | | | | - Dayana Nicté Vergara-Ortega
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico
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Raval M, Gratrix J, Plitt S, Niruban J, Smyczek P, Dong K, Singh AE. Retrospective Cohort Study Examining the Correlates of Reported Lifetime Stimulant Use in Persons Diagnosed With Infectious Syphilis in Alberta, Canada, 2018 to 2019. Sex Transm Dis 2022; 49:551-559. [PMID: 35551418 DOI: 10.1097/olq.0000000000001648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND We sought to examine the correlates for stimulant use in persons diagnosed with infectious syphilis during an outbreak in Alberta to help guide public health interventions. METHODS Infectious syphilis data were extracted from the Communicable Disease and Outbreak Management database from January 1, 2018, to December 31, 2019. Behavioral, demographic, and lifetime reported stimulant use data were obtained. Descriptive analyses and logistic regression were performed for 3 subpopulations (gay, bisexual, and other men who have sex with men; men who have sex with women; and women). RESULTS Of 3627 individuals diagnosed with infectious syphilis, 23.9% (n = 867) cases were not interviewed for substance use and were removed from further analysis. Of the remaining 2759 people, 41.8% (n = 1153) self-reported lifetime stimulant use. Gay, bisexual, and other men who have sex with men reported stimulant use less often than women (24.6% vs. 44.1%; P < 0.0001) and men who have sex with women (24.6% vs. 46.2%; P < 0.0001). Multivariable analyses demonstrated that stimulant use was associated with persons who injected drugs, had correctional involvement, or reported multiple sex partners. Men who have sex with women were more likely to self-report First Nations ethnicity (adjusted odds ratio, 1.76 [95% confidence interval, 1.25-2.49]), and women were more likely to have a concurrent gonorrhea infection (adjusted odds ratio, 1.62 [95% confidence interval, 1.15-2.28]). CONCLUSIONS Nearly half of infectious syphilis cases in Alberta reported lifetime nonprescription stimulant use. Infectious syphilis cases with stimulant use were associated with injection drug use, multiple sex partners, and correctional involvement. Our observations highlight the need for integration of sexual health services into programs for people who use substances and those in corrections custody.
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Affiliation(s)
- Milan Raval
- From the Division of Infectious Diseases, University of Alberta
| | | | - Sabrina Plitt
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario
| | - John Niruban
- Public Health Surveillance and Infrastructure, Alberta Health Services
| | - Petra Smyczek
- STI Services, Alberta Health Services, Edmonton, Alberta
| | - Kathryn Dong
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Ameeta E Singh
- From the Division of Infectious Diseases, University of Alberta
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Sheck I, Tilchin C, Wagner J, Epstein DH, Burgess-Hull A, Jennings JM. Acceptability and Feasibility of Geographically Explicit Ecological Momentary Assessment Among Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2429-2436. [PMID: 34779979 PMCID: PMC9294007 DOI: 10.1007/s10508-021-02159-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Syphilis among men who have sex with men (MSM) has increased greatly in the past twenty years in the U.S. Geographically explicit ecological momentary assessment (GEMA), in which behaviors are geotagged and contextualized in time and space, may contribute to a greater understanding of transmission risk. The objective was to determine the acceptability and feasibility of GEMA for assessing HIV and syphilis transmission risk behaviors among a sample of MSM. Participants responded to a brief survey five times a day for two weeks. Feasibility was measured by participant recruitment, enrollment, prompts received and answered, geotagged prompts, and technical interference with data collection. Acceptability was measured by ratings of enjoyment and willingness for future participation. Summaries of five behavioral measures from the brief survey were calculated. Among the 83 participants contacted, 67.5% (56) expressed interest, 98% (55) were scheduled, and 81.8% (45) were enrolled. Participants answered 78.3% (2,277) of prompts received and 87.7% (1,998) of answered prompts were geotagged. Overall, 70.5% (31) enjoyed participating and 91.1% (41) were willing to participate in the future. Among prompts answered, missingness was low for five behavioral measures (range 0.2% (4) to 0.7% (16)). Feasibility and acceptability were high and missingness was low on behavioral measures in this MSM study population. Most participants reported that they would participate again. Future work should focus on whether GEMA improves our understanding of syphilis and HIV transmission risk.
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Affiliation(s)
- Isabelle Sheck
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, The Johns Hopkins University Bayview Medical Center, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4200, Baltimore, MD, 21224, USA
| | - Carla Tilchin
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, The Johns Hopkins University Bayview Medical Center, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4200, Baltimore, MD, 21224, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jessica Wagner
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, The Johns Hopkins University Bayview Medical Center, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4200, Baltimore, MD, 21224, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David H Epstein
- Intramural Research Program, National Institute on Drug Abuse, The Johns Hopkins University Bayview Medical Center, Baltimore, MD, USA
| | - Albert Burgess-Hull
- Intramural Research Program, National Institute on Drug Abuse, The Johns Hopkins University Bayview Medical Center, Baltimore, MD, USA
| | - Jacky M Jennings
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, The Johns Hopkins University Bayview Medical Center, 5200 Eastern Avenue, Mason F. Lord Bldg, Suite 4200, Baltimore, MD, 21224, USA.
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Tuddenham S, Ghanem KG. Management of Adult Syphilis: Key Questions to Inform the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines. Clin Infect Dis 2022; 74:S127-S133. [PMID: 35416969 PMCID: PMC9006973 DOI: 10.1093/cid/ciac060] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A panel of experts generated 5 "key questions" in the management of adult syphilis. A systematic literature review was conducted and tables of evidence were constructed to answer these questions. Available data suggest no clinical benefit to >1 dose of benzathine penicillin G for early syphilis in human immunodeficiency virus (HIV)-infected patients. While penicillin remains the drug of choice to treat syphilis, doxycycline to treat early and late latent syphilis is an acceptable alternate option if penicillin cannot be used. There are very limited data regarding the impact of additional antibiotic doses on serologic responses in serofast patients and no data on the impact of additional antibiotic courses on long-term clinical outcomes. In patients with isolated ocular or otic signs and symptoms, reactive syphilis serologic results, and confirmed ocular/otic abnormalities at examination, a diagnostic cerebrospinal fluid (CSF) examination is not necessary, because up to 40% and 90% of patients, respectively, would have no CSF abnormalities. Based on the results of 2 studies, repeated CSF examinations are not necessary for HIV-uninfected patients or HIV-infected patients on antiretroviral therapy who exhibit appropriate serologic and clinical responses after treatment for neurosyphilis. Finally, several important gaps were identified and should be a priority for future research.
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Affiliation(s)
- Susan Tuddenham
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Khalil G Ghanem
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Viera A, Sosnowy CD, van den Berg JJ, Mehta NA, Edelman EJ, Kershaw T, Chan PA. Substance Use Treatment Engagement among Men Who Have Sex with Men Who Use Stimulants in the Northeastern United States. Subst Use Misuse 2022; 57:595-602. [PMID: 35068332 PMCID: PMC9343172 DOI: 10.1080/10826084.2022.2026965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Stimulant use is increasing in the United States (U.S.), especially among men who have sex with men (MSM). Objectives: We sought to ascertain barriers and facilitators to substance use treatment utilization among MSM who use stimulants in the northeastern U.S. Methods: We conducted semi-structured interviews with MSM who reported recent stimulant use. Interviews explored perceptions of and experiences with substance use treatment. We used thematic analysis to identify factors that facilitated or impeded substance use treatment engagement. Results: We interviewed 21 MSM in Providence, Rhode Island (n = 15) and New Haven, Connecticut (n = 6). Most participants identified as White (57.1%) and gay (52.4%). Over half (52.4%) screened positive for stimulant use disorder. We identified themes in how participants defined, entered, and engaged in substance use treatment. Participants described treatment to include a variety of modalities, including self-help and peer support groups; they defined treatment as an iterative process. Social networks played both a supportive and obstructive role in treatment entry depending on the relationships and approaches of network members. Meanwhile, social connection during treatment could be both therapeutic (reducing isolation) and counterproductive (precipitating cravings to use). Participants generally expressed a desire for harm reduction approaches to treatment over abstinence-only ones. Finally, participants did not find treatment responsive to their needs as MSM. Conclusion: This study highlights key barriers and facilitators to substance use treatment engagement and underscores the urgent need for culturally-responsive treatment programs that employ harm reduction approaches and are tailored to the unique circumstances of MSM who use stimulants. Supplemental data for this article is available online at http://dx.doi.org/10.1080/10826084.2022.2026965.
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Affiliation(s)
- Adam Viera
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
- Center for Interdisciplinary Research on AIDS, New Haven, Connecticut, USA
| | - Collette D. Sosnowy
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jacob J. van den Berg
- Center for Interdisciplinary Research on AIDS, New Haven, Connecticut, USA
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- Providence/Boston Center for AIDS Research, Rhode Island, USA
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, Massachusetts, USA
| | - Nikita A. Mehta
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - E. Jennifer Edelman
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
- Center for Interdisciplinary Research on AIDS, New Haven, Connecticut, USA
- Yale School of Medicine, Department of Internal Medicine, New Haven, Connecticut, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
- Center for Interdisciplinary Research on AIDS, New Haven, Connecticut, USA
| | - Philip A. Chan
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- Providence/Boston Center for AIDS Research, Rhode Island, USA
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Jennings JM, Wagner J, Tilchin C, Schumacher CM, Thornton N, Hamill MM, Rompalo A, Ruhs S, Rives S, Ghanem KG, Latkin C. Methamphetamine Use, Syphilis, and Specific Online Sex Partner Meeting Venues Are Associated With HIV Status Among Urban Black Gay and Bisexual Men Who Have Sex Men. Sex Transm Dis 2021; 48:S32-S39. [PMID: 33967238 PMCID: PMC8284367 DOI: 10.1097/olq.0000000000001452] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND In the context of increasing syphilis rates, particularly among Black men who have sex men (MSM), the objectives were to determine the associations between methamphetamine (meth) use and syphilis and HIV positivity, and to identify sex partner meeting venues as potential intervention access points among Black MSM in a mid-Atlantic US city. METHODS This study is an ongoing longitudinal cohort study. Participants were recruited from clinical and nonclinical settings and included sexually active MSM aged 18 to 45 years. The baseline visit included a behavioral survey and testing for syphilis, HIV, gonorrhea, and chlamydia. Logistic regression analyses were used for hypothesis testing. RESULTS Among 359 MSM completing baseline, 74.4% (268) Black MSM were included; 31% (84) were aged 24 to 29 years, 43.7% (117) reported unprotected anal intercourse at last sex, and 15.3% (41) reported meth use in the past 3 months. Sixteen percent (43) had syphilis, 46.6% (125) were living with HIV, and 19.0% (51) had gonorrhea and/or chlamydia. Meth use was associated with sexual and drug risk behaviors and HIV, but not syphilis. In adjusted analyses, meth use increased the odds of HIV positivity by 6.43 (95% confidence interval, 2.30-17.98) and syphilis positivity by 2.57 (95% confidence interval, 1.23-5.37). Four online sex partner meeting venues were associated with meth use and HIV, whereas syphilis was associated with one. CONCLUSIONS Among Black MSM, meth use and syphilis positivity were associated with more than 6-fold and almost 3-fold increased adjusted odds of HIV positivity, respectively. Four specific sex partner meeting venues may be important access points for HIV/sexually transmitted infection and substance use prevention.
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Affiliation(s)
- Jacky M. Jennings
- From the Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health
| | - Jessica Wagner
- From the Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine
| | - Carla Tilchin
- From the Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine
| | - Christina M. Schumacher
- From the Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine
| | - Nicole Thornton
- From the Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine
| | | | - Anne Rompalo
- Department of Infectious Disease, Johns Hopkins School of Medicine
| | | | - Sarah Rives
- Department of Infectious Disease, Johns Hopkins School of Medicine
- STI/HIV Program, Baltimore City Health Department, Baltimore, MD
| | - Khalil G. Ghanem
- Department of Infectious Disease, Johns Hopkins School of Medicine
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health
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Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 1062] [Impact Index Per Article: 265.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11-14, 2019. The information in this report updates the 2015 guidelines. These guidelines discuss 1) updated recommendations for treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; 2) addition of metronidazole to the recommended treatment regimen for pelvic inflammatory disease; 3) alternative treatment options for bacterial vaginosis; 4) management of Mycoplasma genitalium; 5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testing among pregnant women; 7) one-time testing for hepatitis C infection; 8) evaluation of men who have sex with men after sexual assault; and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. Physicians and other health care providers can use these guidelines to assist in prevention and treatment of STIs.
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Tsuboi M, Evans J, Davies EP, Rowley J, Korenromp EL, Clayton T, Taylor MM, Mabey D, Chico RM. Prevalence of syphilis among men who have sex with men: a global systematic review and meta-analysis from 2000-20. LANCET GLOBAL HEALTH 2021; 9:e1110-e1118. [PMID: 34246332 PMCID: PMC9150735 DOI: 10.1016/s2214-109x(21)00221-7] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/11/2021] [Accepted: 04/26/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND The WHO Global Health Sector Strategy aims to reduce worldwide syphilis incidence by 90% between 2018 and 2030. If this goal is to be achieved, interventions that target high-burden groups, including men who have sex with men (MSM), will be required. However, there are no global prevalence estimates of syphilis among MSM to serve as a baseline for monitoring or modelling disease burden. We aimed to assess the global prevalence of syphilis among MSM using the available literature. METHODS In this global systematic review and meta-analysis, we searched MEDLINE, Embase, LILACS, and AIM databases, and Integrated Bio-Behavioral Surveillance (IBBS) reports between April 23, 2019, and Feb 1, 2020, to identify studies done between Jan 1, 2000, and Feb 1, 2020, with syphilis point prevalence data measured by biological assay among MSM (defined as people who were assigned as male at birth and had oral or anal sex with at least one other man in their lifetime). Studies were excluded if participants were exclusively HIV-infected MSM, injection-drug users, only seeking care for sexually transmitted infections (STIs) or genital symptoms, or routine STI clinic attendees. Data were extracted onto standardised forms and cross-checked for accuracy and validity. We used random-effects models to generate pooled prevalence estimates across the eight regions of the Sustainable Development Goals. We calculated risk of study bias based on the Appraisal tool for Cross-Sectional Studies, and stratified results based on low versus high risk of bias. This systematic review and meta-analysis was registered with PROSPERO, CRD42019144594. FINDINGS We reviewed 4339 records, 228 IBBS reports, and ten articles from other sources. Of these, 1301 duplicate records were excluded, 2467 records were excluded after title and abstract screening, and 534 articles were excluded after full-text analysis. We identified 345 prevalence data points from 275 studies across 77 countries, with a total of 606 232 participants. Global pooled prevalence from 2000-20 was 7·5% (95% CI 7·0-8·0%), ranging from 1·9% (1·0-3·1%) in Australia and New Zealand to 10·6% (8·5-12·9%) in Latin America and the Caribbean. INTERPRETATION Unacceptably high syphilis prevalence among MSM warrants urgent action. FUNDING Wellcome Trust.
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Affiliation(s)
- Motoyuki Tsuboi
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jayne Evans
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Ella P Davies
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Tim Clayton
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Melanie M Taylor
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland; Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA, USA
| | - David Mabey
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - R Matthew Chico
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
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Quilter LAS, Agnew-Brune C, Broussard D, Salmon M, Bradley H, Hogan V, Ridpath A, Burton K, Rose BC, Kirk N, Reynolds P, Varella L, Granado M, Gerard A, Thompson A, De La Garza G, Lee C, Bernstein K. Establishing Best Practices in a Response to an HIV Cluster: An Example From a Surge Response in West Virginia. Sex Transm Dis 2021; 48:e35-e40. [PMID: 32890333 PMCID: PMC11304816 DOI: 10.1097/olq.0000000000001279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Laura A. S. Quilter
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Christine Agnew-Brune
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dawn Broussard
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Melinda Salmon
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Heather Bradley
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Vicki Hogan
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | - Alison Ridpath
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kenya Burton
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | - Bridget Connard Rose
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | - Nathan Kirk
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | - Pamela Reynolds
- Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV
| | - Lisa Varella
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael Granado
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Anthony Gerard
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Antoine Thompson
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gloria De La Garza
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Chang Lee
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kyle Bernstein
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Muccini C, Crowell TA, Pinyakorn S, Kroon E, Sacdalan C, Ananworanich J, Vasan S, Phanuphak N, Colby DJ. Brief Report: Syphilis Incidence and Effect on Viral Load, CD4, and CD4/CD8 Ratio in a Thai Cohort of Predominantly Men Who Have Sex With Men Living With HIV. J Acquir Immune Defic Syndr 2021; 86:219-223. [PMID: 33433124 DOI: 10.1097/qai.0000000000002542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Syphilis has been increasing in the past years, especially among men who have sex with men (MSM). The aim of the study was to assess syphilis prevalence and incidence and changes in CD4 count and viremia in the RV254 cohort of persons living with HIV who initiated antiretroviral therapy during acute HIV infection (AHI) in Bangkok, Thailand. METHODS From 2009 to 2018, all cohort participants with AHI were tested for syphilis using a qualitative treponemal chemiluminescent microparticle immunoassay and rapid plasma reagin on enrollment, every 24-48 weeks thereafter and when clinically indicated. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for factors associated with incident syphilis. RESULTS Among 579 participants, the median age was 26 (interquartile range: 22-31) years and 564 (97.4%) were men. Syphilis prevalence at enrollment was 14.3% and incidence was 10.2 cases per 100 person-years. Participants with syphilis were more likely to be MSM (HR 3.68, 95% CI: 1.16 to 11.62), use methamphetamine (HR 2.31, 95% CI: 1.51 to 3.54), and have hepatitis C (HR 2.63, 95% CI: 1.59 to 4.34). HIV RNA >50 copies/mL occurred in 6 (3.9%) participants at incident syphilis diagnosis and in 6 (3.9%) after syphilis treatment. Median CD4 count (cells/mm3) declined from 663 before syphilis to 624 at syphilis diagnosis (P = 0.07), rising again to 660 after syphilis treatment. CONCLUSION Syphilis was common in the RV254 cohort, inducing a marginal but significant impact on HIV RNA and a temporary decline in CD4. Syphilis screening and behavioral risk reduction counseling should be implemented for MSM with AHI in Thailand.
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Affiliation(s)
- Camilla Muccini
- Vita-Salute San Raffaele University, Milan, Italy
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Trevor A Crowell
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD; and
| | - Suteeraporn Pinyakorn
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD; and
| | - Eugène Kroon
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Carlo Sacdalan
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Jintanat Ananworanich
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Department of Global Health, the University of Amsterdam, Amsterdam, the Netherlands
| | - Sandhya Vasan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD; and
| | | | - Donn J Colby
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD; and
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Review of sexualized drug use associated with sexually transmitted and blood-borne infections in gay, bisexual and other men who have sex with men. Drug Alcohol Depend 2020; 216:108237. [PMID: 33091811 DOI: 10.1016/j.drugalcdep.2020.108237] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE The aim of the present study was to quantify associations between sexualized drug use (SDU) and sexually-transmitted and blood-borne infection (STBBI) diagnoses in gay, bisexual and other men who have sex with men (GBMSM) with defined temporal proximity between SDU exposure and STBBI diagnoses. METHODS In May 2018 and June 2019, we searched the literature for primary studies that quantified the association between STBBI and SDU among GBMSM. A random-effects model was used to meta-analyze the data and estimate the association between SDU and STBBIs. RESULTS Nineteen studies met the inclusion criteria and fourteen studies were included in the meta-analyses. SDU was associated with higher odds of bacterial STI diagnoses, higher odds of HCV diagnoses, and higher odds of HIV diagnoses. Associations between SDU and diagnoses of bacterial STIs or HCV remained after adjustment for behavioral and sociodemographic factors. CONCLUSIONS Robust and consistent associations between SDU and STBBI identified in this review add to the evidence suggesting SDU is a potential contributor to bacterial STIs and HCV or a proxy indicator for other risk factors.
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Patten S, Doria N, Joy P, Sinno J, Spencer R, Leblanc MA, Holmes D, Numer M. Sexualized drug use in virtual space: A scoping review of how gay, bisexual and other men who have sex with men interact online. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2020. [DOI: 10.3138/cjhs.2019-0052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The purpose of this article is to review the scope of the current literature on sexualized drug use (SDU) among gay, bisexual and other men who have sex with men (GBMSM), particularly in online spaces. Over the last decade, there has been a rapid emergence of online venues for GBMSM to interact for sexual purposes. These spaces have also been infused with various substances that influence or shape the sexual interactions among GBMSM. Employing a scoping review methodology, we explored the interplay between GBMSM, SDU, and online dating and hookup apps. This scoping review presents four themes emerging from the literature: the connection between social networking apps (SNAs) and SDU, the planning and coordination of sex parties, accessing drugs through SNAs, and the coded language that emerges on SNAs. These findings synthesize the important relationship between GBMSM and SDUs, and identify the implications for health promotion.
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Affiliation(s)
- San Patten
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Nicole Doria
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Phillip Joy
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Jad Sinno
- Department of Psychiatry, Dalhousie University, Halifax, NS
| | - Rebecca Spencer
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Marc-Andre Leblanc
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Dave Holmes
- School of Nursing, University of California Irvine, Irvine, CA
| | - Matthew Numer
- School of Health and Human Performance, Dalhousie University, Halifax, NS
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Hampel B, Kusejko K, Kouyos RD, Böni J, Flepp M, Stöckle M, Conen A, Béguelin C, Künzler‐Heule P, Nicca D, Schmidt AJ, Nguyen H, Delaloye J, Rougemont M, Bernasconi E, Rauch A, Günthard HF, Braun DL, Fehr J, Anagnostopoulos A, Battegay M, Bucher HC, Calmy A, Cavassini M, Ciuffi A, Dollenmaier G, Egger M, Elzi L, Fellay J, Furrer H, Fux CA, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Huber M, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kovari H, Ledergerber B, Martinetti G, Martinez de Tejada B, Marzolini C, Metzner KJ, Müller N, Paioni P, Pantaleo G, Perreau M, Rudin C, Scherrer AU, Schmid P, Speck R, Tarr P, Trkola A, Vernazza P, Wandeler G, Weber R, Yerly S. Chemsex drugs on the rise: a longitudinal analysis of the Swiss HIV Cohort Study from 2007 to 2017. HIV Med 2020; 21:228-239. [DOI: 10.1111/hiv.12821] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/22/2022]
Affiliation(s)
- B Hampel
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
- Department of Public Health Epidemiology, Biostatistics and Public Health Institute University of Zurich Zurich Switzerland
| | - K Kusejko
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - RD Kouyos
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - J Böni
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - M Flepp
- Center of Infectious Diseases Zurich Zurich Switzerland
| | - M Stöckle
- Division of Infectious Diseases & Hospital Epidemiology University Hospital Basel University Basel Basel Switzerland
| | - A Conen
- Division of Infectious Diseases and Hospital Hygiene Cantonal Hospital Aarau Aarau Switzerland
| | - C Béguelin
- Department of Infectious Diseases Bern University Hospital University of Bern Bern Switzerland
| | - P Künzler‐Heule
- Institute of Nursing Science University of Basel, and University Hospital Basel Basel Switzerland
| | - D Nicca
- Institute of Nursing Science University of Basel, and University Hospital Basel Basel Switzerland
| | - AJ Schmidt
- Division of Infectious Diseases Cantonal Hospital St. Gallen St. Gallen Switzerland
| | - H Nguyen
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - J Delaloye
- Division of Infectious Diseases University Hospital Lausanne Lausanne Switzerland
| | - M Rougemont
- Division of Infectious Diseases University Hospital Geneva Geneva Switzerland
| | - E Bernasconi
- Division of Infectious Diseases Regional Hospital Lugano Lugano Switzerland
| | - A Rauch
- Department of Infectious Diseases Bern University Hospital University of Bern Bern Switzerland
| | - HF Günthard
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - DL Braun
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - J Fehr
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Department of Public Health Epidemiology, Biostatistics and Public Health Institute University of Zurich Zurich Switzerland
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Roy M, Ahmad S, Roy AK. Rare presentation of vertebral discitis, osteomyelitis and polyarticular septic arthritis due to disseminated Neisseria gonorrhea infection. J Community Hosp Intern Med Perspect 2020; 10:55-59. [PMID: 32128060 PMCID: PMC7034487 DOI: 10.1080/20009666.2019.1710930] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/12/2019] [Indexed: 11/19/2022] Open
Abstract
Disseminated Neisseria gonorrhea (N. Gonorrhoeae) infection can present with polyarticular involvement. Acute vertebral discitis/osteomyelitis due to this organism infection has been rarely reported. We present a case of vertebral discitis and osteomyelitis due to N. gonorrhea in an immunocompetent host, treated successfully with a prolonged antibiotic course.
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Affiliation(s)
- Moni Roy
- Department of Internal Medicine, University of Illinois College of Medicine, OSF Saint Francis Medical
Center, Peoria, IL, USA
| | - Sharjeel Ahmad
- Section of Infectious Diseases, Department of Internal
Medicine, University of Illinois College of Medicine, Peoria, IL, USA
| | - Ashish Kumar Roy
- Department of Internal Medicine, OSF Saint Francis Medical Center, Peoria, IL, USA
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Historical and Current Trends in the Epidemiology of Early Syphilis in San Francisco, 1955 to 2016. Sex Transm Dis 2019; 45:S55-S62. [PMID: 29787467 DOI: 10.1097/olq.0000000000000870] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Seventeen years into a sustained epidemic, early syphilis (ES) rates in San Francisco (SF) are continuing to increase and the demographics of the affected population are changing. We provide a historical overview of ES in SF among men who have sex with men (MSM) and describe trends in the epidemiology and disease investigation outcomes. METHODS We examined data from the SF Department of Public Health's patient-based registry of integrated STD surveillance, clinical, and field investigation data to describe demographic and behavioral characteristics of ES cases, as well as outcomes of syphilis partner services (PS). χ Tests were performed to examine categorical differences across periods. Analysis of variance was used to examine differences in continuous variables. RESULTS In 2016, 1095 ES cases were reported among males in SF, a 219% increase from the 343 cases identified 10 years ago. Between 1996-1999 and 2010-2016, an increasing proportion of ES cases were among MSM younger than 25 years, nonwhite, and HIV negative (P < 0.05). A decreasing proportion of ES cases were assigned for PS, among whom a smaller proportion of reported sex partners were identified by name, resulting in an overall decline in the proportion of cases who had at least one named partner treated as a result of PS (Disease Intervention Rate) from 30.5 in 2000-2004 to 14.8 in 2010-2016. CONCLUSIONS Syphilis case rates continue to increase in SF and the epidemic is expanding beyond a core population. Additional resources and innovative prevention approaches are needed to reduce the burden of syphilis among MSM.
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Comparison of Algorithms to Triage Patients to Express Care in a Sexually Transmitted Disease Clinic. Sex Transm Dis 2019; 45:696-702. [PMID: 29634599 DOI: 10.1097/olq.0000000000000854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The ideal approach to triaging sexually transmitted disease (STD) clinic patients between testing-only express visits and standard visits with clinician evaluation is uncertain. METHODS In this cross-sectional study, we used classification and regression tree analysis to develop and validate the optimal algorithm for predicting which patients need a standard visit with clinician assessment (i.e., to maximize correct triage). Using electronic medical record data, we defined patients as needing a standard visit if they reported STD symptoms, received any empiric treatment, or were diagnosed as having an infection or syndrome at the same visit. We considered 11 potential predictors for requiring medical evaluation collected via computer-assisted self-interview when constructing the optimized algorithm. We compared test characteristics of the optimized algorithm, the Public Health-Seattle and King County STD Clinic's current 13-component algorithm, and a simple 2-component algorithm including only presence of symptoms and contact to STD. RESULTS From October 2010 to June 2015, 18,653 unique patients completed a computer-assisted self-interview. In the validation samples, the optimized, current, and simple algorithms appropriately triaged 90%, 85%, and 89% of patients, respectively. The optimized algorithm had lower sensitivity for identifying patients needing standard visits (men, 94%; women, 93%) compared with the current algorithm (men, 95%; women, 98%), as did the simple algorithm (men, 91%; women, 93%). The optimized, current, and simple algorithms triaged 31%, 23%, and 33% of patients to express visits, respectively. CONCLUSIONS The overall performance of the statistically optimized algorithm did not differ meaningfully from a simple 2-component algorithm. In contrast, the current algorithm had the highest sensitivity but lowest overall performance.
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Fight Fire With Fire: Innovations to Address Syphilis Among Men Who Have Sex With Men. Sex Transm Dis 2019; 45:e85-e86. [PMID: 29965945 DOI: 10.1097/olq.0000000000000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mayer KH, Allan‐Blitz L. Similar, but different: drivers of the disproportionate HIV and sexually transmitted infection burden of key populations. J Int AIDS Soc 2019; 22 Suppl 6:e25344. [PMID: 31468653 PMCID: PMC6716057 DOI: 10.1002/jia2.25344] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 06/18/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- Kenneth H Mayer
- Beth Israel Deaconess Medical CenterHarvard Medical SchoolThe Fenway InstituteBostonMA
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Saberi P, Neilands TB, Lally MA, Hosek SG, Hightow-Weidman L. The Association between Use of Online Social Networks to Find Sex Partners and Sexually Transmitted Infection Diagnosis among Young Men Who Have Sex with Men and Transgender Women Living with HIV. J Int Assoc Provid AIDS Care 2019; 18:2325958219867324. [PMID: 31389285 PMCID: PMC6900576 DOI: 10.1177/2325958219867324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/23/2019] [Accepted: 07/02/2019] [Indexed: 11/17/2022] Open
Abstract
We conducted a cross-sectional analysis of baseline data from the Adolescent Trials Network for HIV/AIDS Interventions to examine the association between the use of social media sites to find sex partners and recent diagnosis of sexually transmitted infections (STIs) among 13- to 24-year-old men who have sex with men and transgender women living with HIV. We used linear regression to determine the relationship between the number of STIs and the number of social media sites used to find sex partners with each type of sex act included in the analysis. Secondary analyses substituted frequency of social media site use for number of social media sites. Among 741 participants, for every 1 social media account used to find sex partners, there was a 2.53% (95% confidence interval: 0.28-5.54) increase in STIs. This association was mediated through condomless receptive anal intercourse or condomless insertive anal intercourse but not barrierless oral intercourse. Similar but attenuated associations were found when frequency of social media site use was substituted for number of social media sites. Future research should examine innovative interventions on these social media sites with respect for its users.
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Affiliation(s)
- Parya Saberi
- Department of Medicine, University of California San Francisco, San
Francisco, CA, USA
| | - Torsten B. Neilands
- Department of Medicine, University of California San Francisco, San
Francisco, CA, USA
| | - Michelle A. Lally
- Department of Medicine, Alpert Medical School of Brown University and
Lifespan Hospital System, Providence, RI, USA
| | - Sybil G. Hosek
- Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL,
USA
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Yang C, Latkin C, Tobin K, Seal D, Koblin B, Chander G, Siconolfi D, Flores S, Spikes P. An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study. AIDS Behav 2018; 22:2224-2234. [PMID: 29779160 PMCID: PMC6021207 DOI: 10.1007/s10461-018-2161-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Despite the high HIV incidence and prevalence among black men who have sex with men (BMSM), little research has examined partner characteristics, partner seeking venue, sexual position, substance use, and sexual risk behavior at the sex event-level among BMSM. Using the baseline data from a multi-site study of 807 BMSM stratified by their HIV status, the goal of this study was to conduct a detailed event-level analysis of 1577 male anal sex events to assess the factors associated with condomless anal intercourse (CLAI) with a HIV-discordant or HIV status-unknown partner. We found CLAI with an HIV-discordant or unknown HIV status partner among HIV-negative BMSM was negatively associated with having sex with a main partner, and was positively associated with taking both receptive and insertive sexual positions during sex. As compared to a sex partner met at bar, night club or dance club, HIV-positive BMSM were less likely to engage in CLAI with HIV-discordant and unknown HIV status partner met at party or friend's house or at community organizations. HIV-positive BMSM had lower odds of engaging in CLAI with HIV-discordant and unknown HIV status partner if they had insertive sexual position or both receptive and insertive sexual positions. These results underscore the importance of delineating unique sex event-level factors associated with sexual risk behavior depending on individuals' HIV status. Our findings suggest event-level partner characteristics, sexual position, and partner seeking venues may contribute to disparities in HIV incidence.
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Affiliation(s)
- Cui Yang
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD, 21205, USA.
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD, 21205, USA
| | - Karin Tobin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD, 21205, USA
| | - David Seal
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Beryl Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Geetanjali Chander
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Stephen Flores
- National Center for HIV/AIDS, Viral, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pilgrim Spikes
- National Center for HIV/AIDS, Viral, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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25
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Tomkins A, George R, Kliner M. Sexualised drug taking among men who have sex with men: a systematic review. Perspect Public Health 2018; 139:23-33. [PMID: 29846139 DOI: 10.1177/1757913918778872] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS: Sexualised drug taking is increasingly reported on national and international levels. We aim to review existing evidence of the relationship between recreational drug use (RDU) and sexual intercourse among men who have sex with men (MSM). METHODS: We reviewed published abstracts and full articles identified from Cochrane, MEDLINE and Embase databases from November 2010 to 2017. We included any existing studies investigating RDU in MSM and at least one of the following: high-risk sexual practices, sexually transmitted infections (STIs) or barriers to accessing specialist support. RESULTS: In total, 112 studies were included. Of them, 38 studies specifically reported the prevalence of chemsex-related drug use. Links with sexualised drug taking and high-risk sexual practices including condomless sex and group sex were reported by several studies. Recreational drug use in the sexual setting appears linked to the acquisition of STIs, including hepatitis C, syphilis and gonorrhoea. Reports of adverse mental health outcomes are increasingly described, with several studies documenting chemsex-related inpatient admission. A paucity of research addressing barriers to those accessing specialist drug support services was identified. CONCLUSION: This review demonstrates the complex interplay between recreational drug use, high-risk sexual practices and STIs. It identifies the description of adverse mental health outcomes in the chemsex setting, thus highlighting the need for a multidisciplinary approach across specialties in the management of those adversely affected. Finally, it illuminates the need for future research into perceived barriers of those who require access to support services to ensure timely and comprehensive support provision.
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Affiliation(s)
- Andrew Tomkins
- Manchester University Hospitals NHS Foundation Trust, The Hathersage Centre, Manchester M13 9WL, UK.,The Northern Integrated Contraception, Sexual Health & HIV Service, Manchester, UK
| | - Ryan George
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Merav Kliner
- Public Health England North West, Manchester, UK
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26
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Bryant J, Hopwood M, Dowsett GW, Aggleton P, Holt M, Lea T, Drysdale K, Treloar C. The rush to risk when interrogating the relationship between methamphetamine use and sexual practice among gay and bisexual men. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 55:242-248. [DOI: 10.1016/j.drugpo.2017.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/01/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
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27
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Spicknall IH, Gift TL, Bernstein KT, Aral SO. Sexual networks and infection transmission networks among men who have sex with men as causes of disparity and targets of prevention. Sex Transm Infect 2017; 93:307-308. [DOI: 10.1136/sextrans-2016-052676] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/09/2017] [Accepted: 03/16/2017] [Indexed: 11/04/2022] Open
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28
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Viswanath H, Wilkerson JM, Breckenridge E, Selwyn BJ. Life Chaos and Perceived Social Support Among Methamphetamine-Using Men Who Have Sex With Men Engaging in Transactional Sexual Encounters. Subst Use Misuse 2017; 52:100-107. [PMID: 27679931 PMCID: PMC5344650 DOI: 10.1080/10826084.2016.1222620] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Social support and life chaos have been inversely associated with increased risk of HIV infection. The purpose of this study was to explore among a sample of HIV-negative methamphetamine-using men who have sex with men (MSM) the association between engaging in transactional sex, life chaos, and low social support. METHODS HIV-negative methamphetamine-using MSM completed an online questionnaire between July and October 2012 about recent substance use and sexual behavior. Bivariate and multivariate tests were used to obtain statistically significant associations between demographic characteristics, engaging in transactional sex, life chaos, and the participants' perception of their social support. RESULTS Of the 325 participants, 23.7% reported engaging in transactional sex, 45.2% reported high life chaos, and 53.5% reported low perceived social support. Participants who engaged in transactional sex were more likely to have high life chaos than participants who did not (aOR = 1.70, 95% CI = [1.01, 2.84]); transactional sex was not associated with social support. Participants with high life chaos were more out about their sexual orientation (aOR = 2.29, 95% CI = [1.18, 4.42]) and more likely to perceive they had low social support (aOR = 3.78, 95% CI = [2.31, 6.22]) than participants with low life chaos. Non-Latinos perceived they had less social support than Latinos (aOR = 0.48, 95% CI = [0.25, 0.92]). CONCLUSIONS Methamphetamine-using MSM engaging in transactional sex experience more life chaos than those who do not engage in transactional sex. Outness, perceived social support, and ethnicity are associated with life chaos.
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Affiliation(s)
- Humsini Viswanath
- a Center for Health Promotion and Prevention Research , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - J Michael Wilkerson
- a Center for Health Promotion and Prevention Research , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Ellen Breckenridge
- a Center for Health Promotion and Prevention Research , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Beatrice J Selwyn
- a Center for Health Promotion and Prevention Research , The University of Texas Health Science Center at Houston , Houston , Texas , USA
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29
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Abara WE, Hess KL, Neblett Fanfair R, Bernstein KT, Paz-Bailey G. Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe: A Systematic Review of Trend Studies Published between 2004 and 2015. PLoS One 2016; 11:e0159309. [PMID: 27447943 PMCID: PMC4957774 DOI: 10.1371/journal.pone.0159309] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 06/30/2016] [Indexed: 01/09/2023] Open
Abstract
Globally, men who have sex with men (MSM) are disproportionately burdened with syphilis. This review describes the published literature on trends in syphilis infections among MSM in the US and Western Europe from 1998, the period with the fewest syphilis infections in both geographical areas, onwards. We also describe disparities in syphilis trends among various sub-populations of MSM. We searched electronic databases (Medline, Embase, Global Health, PsychInfo, CAB Abstracts, CINAHL, Sociological Abstracts, Web of Science, Cochrane Library, and LILACS) for peer-reviewed journal articles that were published between January 2004 and June 2015 and reported on syphilis cases among MSM at multiple time points from 1998 onwards. Ten articles (12 syphilis trend studies/reports) from the US and eight articles (12 syphilis trend studies/reports) from Western Europe were identified and included in this review. Taken together, our findings indicate an increase in the numbers and rates (per 100,000) of syphilis infections among MSM in the US and Western Europe since 1998. Disparities in the syphilis trends among MSM were also noted, with greater increases observed among HIV-positive MSM than HIV-negative MSM in both the US and Western Europe. In the US, racial minority MSM and MSM between 20 and 29 years accounted for the greatest increases in syphilis infections over time whereas White MSM accounted for most syphilis infections over time in Western Europe. Multiple strategies, including strengthening and targeting current syphilis screening and testing programs, and the prompt treatment of syphilis cases are warranted to address the increase in syphilis infections among all MSM in the US and Western Europe, but particularly among HIV-infected MSM, racial minority MSM, and young MSM in the US.
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Affiliation(s)
- Winston E. Abara
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristen L. Hess
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robyn Neblett Fanfair
- Division of STD Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kyle T. Bernstein
- Division of STD Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gabriela Paz-Bailey
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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30
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Thienkrua W, Todd CS, Chonwattana W, Wimonsate W, Chaikummao S, Varangrat A, Chitwarakorn A, van Griensven F, Holtz TH. Incidence of and temporal relationships between HIV, herpes simplex II virus, and syphilis among men who have sex with men in Bangkok, Thailand: an observational cohort. BMC Infect Dis 2016; 16:340. [PMID: 27449012 PMCID: PMC4957431 DOI: 10.1186/s12879-016-1667-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 06/27/2016] [Indexed: 11/11/2022] Open
Abstract
Background High HIV incidence has been detected among men who have sex with men (MSM) in Thailand, but the relationship and timing of HIV, herpes simplex virus 2 (HSV-2), and syphilis is unknown. This analysis measures incidence, temporal relationships, and risk factors for HIV, HSV-2, and syphilis among at-risk MSM in the Bangkok MSM Cohort Study. Methods Between April 2006 and December 2010, 960 men negative for HIV, HSV-2, and syphilis at entry enrolled and contributed 12–60 months of follow-up data. Behavioral questionnaires were administered at each visit; testing for HIV antibody was performed at each visit, while testing for syphilis and HSV-2 were performed at 12 month intervals. We calculated HIV, HSV-2, and syphilis incidence, assessed risk factors with complementary log-log regression, and among co-infected men, measured temporal relationships between infections with Kaplan-Meier survival analysis and paired t-test. Results The total number of infections and incidence density for HIV, HSV-2, and syphilis were 159 infections and 4.7 cases/100 PY (95 % Confidence Interval (CI): 4.0–5.4), 128 infections and 4.5/100 PY (95 % CI: 3.9–5.5), and 65 infections and 1.9/100 PY (95 % CI: 1.5–2.5), respectively. Among men acquiring >1 infection during the cohort period, mean time to HIV and HSV-2 infection was similar (2.5 vs. 2.9 years; p = 0.24), while syphilis occurred significantly later following HIV (4.0 vs. 2.8 years, p < 0.01) or HSV-2 (3.8 vs. 2.8 years, p = 0.04) infection. The strongest independent predictor of any single infection in adjusted analysis was acquisition of another infection; risk of syphilis (Adjusted Hazards Ratio (AHR) = 3.49, 95 % CI: 1.89–6.42) or HIV (AHR = 2.26, 95 % CI: 1.47–3.48) acquisition during the cohort was significantly higher among men with incident HSV-2 infection. No single independent behavioral factor was common to HIV, HSV-2, and syphilis acquisition. Conclusion HIV and HSV-2 incidence was high among this Thai MSM cohort. However, acquisition of HIV and co-infection with either HSV-2 or syphilis was low during the time frame men were in the cohort. Evaluation of behavioral risk factors for these infections suggests different risks and possible different networks.
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Affiliation(s)
- Warunee Thienkrua
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Catherine S Todd
- FHI 360 Asia-Pacific Regional Office, 9th Floor, Tower 3, Sindhorn Building, 130-132 Wireless Road, Lumpini, Phatumwan, Bangkok, 10330, Thailand.
| | - Wannee Chonwattana
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Wipas Wimonsate
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Supaporn Chaikummao
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Anchalee Varangrat
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Anupong Chitwarakorn
- Department of Disease Control, DDC 7 Building, 1st Floor Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Frits van Griensven
- Thai Red Cross HIV Research Center, 104 Rajdamri Road, Pathum Wan, Bangkok, 10330, Thailand.,Division of Preventive Medicine and Public Health, School of Medicine, University of California-San Francisco, 50 Beale Street, Ste 1200, San Francisco, 94105, CA, USA
| | - Timothy H Holtz
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand.,Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, 30329, GA, USA
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31
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Diesterheft R, Brady JP, Shattell M. Risk behaviours of an interrelated syphilis-infected sexual network of men who have sex with men. J Clin Nurs 2016; 25:3597-3604. [PMID: 27104302 DOI: 10.1111/jocn.13209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 12/17/2022]
Abstract
AIMS AND OBJECTIVES We examined the risk behaviours in an interrelated sexual network of 33 syphilis-infected men who have sex with men on the use of condoms, substances and websites to meet sexual partners. Our study used a descriptive exploratory design to investigate co-occurring high-risk behaviours in this interrelated sexual network to inform future health interventions and research directions. BACKGROUND Although the risk behaviours for human immunodeficiency virus transmission in men who have sex with men have been studied, few have studied the high-risk population of men who already have syphilis, and even fewer have studied the risk behaviours in sexual networks of syphilis-infected men who have sex with men who were identified using contact tracing. DESIGN/METHODS The data were collected from semi-structured, individual interviews at a not-for-profit lesbian, gay, bisexual and transgender health centre in a large city in the Midwestern USA. RESULTS Inconsistent condom use was substantial during both insertive (92%) and receptive (88%) anal intercourse. Most participants (97%) reported using one or more substances prior to or during anal intercourse, and Internet websites were the most common place to meet sexual partners (88%). CONCLUSIONS High-risk behaviours were significant within this syphilis-infected sexual network of men who have sex with men. The majority of our 33 participants were non-Hispanic Whites (n = 27, 82%), possessed a baccalaureate degree or higher (n = 23, 70%), and actively sought out unprotected anal intercourse [21 participants (64%) used BareBackRT.com, a website to seek out unprotected anal intercourse]. RELEVANCE TO CLINICAL PRACTICE Nurses should be more informed about the risk factors of a high-risk sexual network of syphilis-infected men who have sex with men. Interrelated sexual networks have high levels of similarity among participants' high-risk behaviours; contact tracing may be used to identify individual participants for relevant risk-reduction interventions.
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Affiliation(s)
| | - John P Brady
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Mona Shattell
- School of Nursing, DePaul University, Chicago, IL, USA.,Department of Community, Systems, and Mental Health Nursing, Rush University, DePaul University, Chicago, IL, USA
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32
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Cunningham S, Finlay K, Stoecker C. Is Mississippi's prescription-only precursor control law a prescription to decrease the production and raise the price of methamphetamine? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:1144-9. [PMID: 26187186 DOI: 10.1016/j.drugpo.2015.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 05/14/2015] [Accepted: 05/28/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND In 2010, Mississippi became the second state to require a prescription to purchase pseudoephedrine-based medications. Proponents of "prescription-only" laws argue that they are necessary to disrupt methamphetamine markets, but critics note the costs to legal consumers of cold medications may offset some of the laws' intended benefits. OBJECTIVE We evaluated the effect of prescription-only restrictions for methamphetamine precursors on state-level methamphetamine lab seizures and methamphetamine prices. METHODS We used a synthetic control approach to create a control state comparable to Mississippi and then used permutation testing to determine if the resulting difference was statistically significant. RESULTS We found that Mississippi's prescription-only law removed 2637 small methamphetamine labs in the two years after the law became effective, which represents a 77% reduction in small labs relative to the synthetic counterfactual. We found no evidence that the law impacted methamphetamine prices. CONCLUSION We conclude that while prescription-only laws can reduce the number of domestic small methamphetamine labs in operation, methamphetamine availability is unlikely to be materially impacted.
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Affiliation(s)
- Scott Cunningham
- Department of Economics, Baylor University, Waco, TX, United States
| | - Keith Finlay
- Department of Economics, Tulane University, New Orleans, LA, United States
| | - Charles Stoecker
- Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States.
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33
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Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64:1-137. [PMID: 26042815 PMCID: PMC5885289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR-12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.
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Affiliation(s)
- Kimberly A. Workowski
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
- Emory University, Atlanta, Georgia
| | - Gail A. Bolan
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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34
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Mayer KH, Krakower DS. Editorial Commentary:Uncoupling Epidemiological Synergy: New Opportunities for HIV Prevention for Men Who Have Sex With Men. Clin Infect Dis 2015; 61:288-90. [DOI: 10.1093/cid/civ291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 04/01/2015] [Indexed: 01/30/2023] Open
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35
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Salamanca SA, Sorrentino EE, Nosanchuk JD, Martinez LR. Impact of methamphetamine on infection and immunity. Front Neurosci 2015; 8:445. [PMID: 25628526 PMCID: PMC4290678 DOI: 10.3389/fnins.2014.00445] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/17/2014] [Indexed: 12/21/2022] Open
Abstract
The prevalence of methamphetamine (METH) use is estimated at ~35 million people worldwide, with over 10 million users in the United States. METH use elicits a myriad of social consequences and the behavioral impact of the drug is well understood. However, new information has recently emerged detailing the devastating effects of METH on host immunity, increasing the acquisition of diverse pathogens and exacerbating the severity of disease. These outcomes manifest as modifications in protective physical and chemical defenses, pro-inflammatory responses, and the induction of oxidative stress pathways. Through these processes, significant neurotoxicities arise, and, as such, chronic abusers with these conditions are at a higher risk for heightened consequences. METH use also influences the adaptive immune response, permitting the unrestrained development of opportunistic diseases. In this review, we discuss recent literature addressing the impact of METH on infection and immunity, and identify areas ripe for future investigation.
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Affiliation(s)
- Sergio A Salamanca
- Department of Biomedical Sciences, Long Island University-Post Brookville, NY, USA
| | - Edra E Sorrentino
- Department of Biomedical Sciences, Long Island University-Post Brookville, NY, USA
| | - Joshua D Nosanchuk
- Microbiology and Immunology, Albert Einstein College of Medicine Bronx, NY, USA ; Medicine (Division of Infectious Diseases), Albert Einstein College of Medicine Bronx, NY, USA
| | - Luis R Martinez
- Department of Biomedical Sciences, NYIT College of Osteopathic Medicine, New York Institute of Technology Old Westbury, NY, USA
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36
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Solomon MM, Mayer KH. Evolution of the syphilis epidemic among men who have sex with men. Sex Health 2015; 12:96-102. [PMID: 25514173 DOI: 10.1071/sh14173] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 10/03/2014] [Indexed: 12/21/2022]
Abstract
Syphilis has existed for millenni, but its epidemiology was only recently linked to men who have sex with men (MSM) after the introduction of penicillin in the 1940s; the syphilis epidemic became concentrated within the MSM community in subsequent decades. The HIV/AIDS epidemic in the 1980s led to a surge of new syphilis cases and revealed the potentiation between HIV and syphilis, as evidenced by a shift in the natural history of neurosyphilis. In response, MSM revolutionised their sexual behaviour by implementing community-driven seroadaptive strategies to stem HIV transmission. The Centers for Disease Control in the US called for the elimination of syphilis in the late 1990s since the rates had fallen sharply but this effort was overtaken by a resurgence of global outbreaks among MSM in the 2000s, many of which were linked to methamphetamine use and sexual networking websites. Syphilis remains highly prevalent today, especially among MSM and individuals infected with HIV, and it continues to present a significant public health conundrum. Innovative syphilis prevention strategies are warranted. MSM engaging in high-risk behaviour such as condomless anal receptive intercourse, sex with multiple partners or recreational drug use should be routinely screened for syphilis infection; they should also be counselled about the limits of seroadaptive behaviours and HIV pre-exposure prophylaxis as they relate to syphilis transmission.
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Affiliation(s)
- Marc M Solomon
- Gladstone Institutes of Virology and Immunology, 1650 Owens Street, 5th Floor, San Francisco, CA 94158, USA
| | - Kenneth H Mayer
- Fenway Institute, Fenway Health, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
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37
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Stoltey JE, Cohen SE. Syphilis transmission: a review of the current evidence. Sex Health 2015; 12:103-9. [PMID: 25702043 DOI: 10.1071/sh14174] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 12/22/2014] [Indexed: 11/23/2022]
Abstract
Syphilis remains widespread worldwide, with increasing rates among men who have sex with men. This paper reviews available evidence regarding syphilis transmission, including data on: sexual transmission (transmission probability per sexual partnership), vertical transmission, transmission via blood products and organ donation, and other rare modes of transmission. In addition, host susceptibility to syphilis infection is discussed. Syphilis screening and treatment, condoms and risk-reduction counselling and how they modify syphilis transmission dynamics are considered.
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Affiliation(s)
- Juliet E Stoltey
- University of California, San Francisco - Division of Infectious Diseases, 513 Parnassus Avenue, Box 0654, San Francisco, CA 94143, USA
| | - Stephanie E Cohen
- San Francisco Department of Public Health, 356 7th Street, San Francisco, CA 94103, USA
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38
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Virtual versus physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia? AIDS Behav 2014; 18:1428-35. [PMID: 24077974 DOI: 10.1007/s10461-013-0628-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Increasing use of the Internet to seek sex partners is accompanied by rising HIV infections among men who have sex with men (MSM) in East and South-East Asia. We examined whether the Internet facilitates greater HIV risk taking among MSM in the region. A cross-sectional sample of 9,367 MSM was recruited via the Internet in 2010. We compared socio-demographic and HIV-related behavioral characteristics among MSM who met sex partners on the Internet only, who met sex partners offline only, and who met sex partners through both. Multinomial logistic regression was used to identify independent correlates that were associated with differences in where participants met their male sex partners. Compared to MSM who met partners offline only, those who met partners online only were less likely to have multiple male sex partners, have paid for sex, have consumed recreational drugs, and have used alcohol before sex. MSM who met partners both online and offline appeared to be the riskiest group that they were more likely to have multiple male sex partners, have engaged in UIAI, and have consumed alcohol before sex. These findings suggest that social networking websites alone do not facilitate greater HIV risk taking among MSM. Rather, they provide additional venues for MSM who already engage in HIV-related high risk behaviors to seek sex partners. The Internet offers incredible opportunities to reach large numbers of MSM in East and South-East Asia for HIV prevention and research. Web-based outreach and prevention activities are needed to reach these men. In addition, mobile and application-based interventions should also be developed and disseminated.
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Beymer MR, Weiss RE, Bolan RK, Rudy ET, Bourque LB, Rodriguez JP, Morisky DE. Sex on demand: geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles County. Sex Transm Infect 2014; 90:567-72. [PMID: 24926041 DOI: 10.1136/sextrans-2013-051494] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Geosocial networking applications (GSN apps) used for meeting sexual partners have become increasingly popular with men who have sex with men (MSM) since 2009. The current study aimed to determine if self-identified HIV-negative, MSM clinic attendees who used GSN apps have an increased incidence of sexually transmitted infections (STI) compared to self-identified HIV-negative, MSM attendees who met sexual partners via in-person venues, such as bars or clubs or through MSM-specific hook-up websites. METHODS Data were collected between August 2011 and January 2013 on all self-identified HIV-negative, MSM clients visiting the L.A. Gay & Lesbian Center for STI screening. A total of 7184 individuals tested for STIs and self-reported behaviours on drug use and social networking methods to meet sexual partners. Multivariate logistic regression models were used to analyse the results. RESULTS Individuals who used GSN apps for meeting sexual partners had greater odds of testing positive for gonorrhoea (OR: 1.25; 95% CI 1.06 to 1.48) and for chlamydia (OR: 1.37; 95% CI 1.13 to 1.65) compared to individuals who met partners through in-person methods only. There were no significant differences in syphilis and HIV incidence between those who met partners via in-person venues only, on the internet or through GSN apps. CONCLUSIONS The present study concludes that sexual health clinic MSM attendees who are meeting on GSN apps are at greater risk for gonorrhoea and chlamydia than MSM attendees who meet in-person or on the internet. Future interventions should explore the use of these novel technologies for testing promotion, prevention and education.
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Affiliation(s)
- Matthew R Beymer
- L.A. Gay & Lesbian Center, Los Angeles, California, USA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Robert E Weiss
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | | | - Ellen T Rudy
- County of Los Angeles Department of Public Health, Sexually Transmitted Disease Program, Los Angeles, California, USA
| | - Linda B Bourque
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | | | - Donald E Morisky
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
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