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Cannovo N, Bianchini E, Gironacci L, Garbati E, Di Prospero F, Cingolani M, Scendoni R, Fedeli P. Sexually Transmitted Infections in Adolescents and Young Adults: A Cross Section of Public Health. Int J Environ Res Public Health 2024; 21:501. [PMID: 38673412 PMCID: PMC11050350 DOI: 10.3390/ijerph21040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Sexually transmitted infections (STIs) can be caused by a number of microorganisms that vary greatly in size, life cycle, clinical manifestations, and sensitivity to available treatments. Transmission of STIs can occur during unprotected (or condomless) sexual contact and through the exchange of body fluids during any type of activity. The prevalence of sexually transmitted diseases remains high in the world, despite diagnostic and therapeutic improvements for these infectious diseases that rapidly eliminate the contagiousness of patients. Our study determines the prevalence of STI pathogens in adolescents and young adults in the population of the Province of Macerata (Italy). We will analyze data in correspondence to age and gender, and we will compare our results to international studies. MATERIALS AND METHOD We analyzed STI test results from the entire database of a Provincial Health Authority for the period 2021-2022. The samples came from the following age groups: 0-12, 13-18, 19-25, and 26-35 from 2021 to 2022. The results came from vaginal and cervical swabs (for females); urethral, rectal, and pharyngeal swabs (for males and females); and seminal fluid (for males) for the following infections: HPV, Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasmas, Gardnerella, Trichomonas vaginalis, Neisseria gonorrhoeae, and Treponema pallidum. The results also came from blood tests for HIV, hepatitis C, hepatitis B, and Treponema pallidum (TPHA, VDRL). In addition, we examined results from urine tests for chlamydia, Neisseria gonorrhoeae, trichomonas, and Treponema pallidum. CONCLUSIONS The literature for other countries reports the need for comprehensive, culturally and developmentally sensitive care to address sexuality-related issues in adolescents and young adults, a need that also applies to Italy. These data will be of great importance in adopting evidence-based STI control programs in Marche Region. This study could, indeed, represent a landmark for public health officials and professionals, with the aim of promoting adolescents' access to sexual health services to receive useful information, strengthening preventive measures in younger age groups, and designing sexual education programs.
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Affiliation(s)
- Nunzia Cannovo
- Legal Medicine Unit, Local Health Authority (AST) 3, 62032 Camerino, Italy;
| | - Elena Bianchini
- Clinical Governance and Risk Unit, Macerata Hospital, Local Health Authority (AST) 3, 62100 Macerata, Italy;
| | - Luciana Gironacci
- Analysis Laboratory Unit, Local Health Authority (AST) 3, 62012 Civitanova Marche, Italy;
| | - Elisabetta Garbati
- Gynecology and Obstetrics Unit, Civitanova Marche Hospital, Local Health Authority (AST) 3, 62012 Civitanova Marche, Italy; (E.G.); (F.D.P.)
| | - Filiberto Di Prospero
- Gynecology and Obstetrics Unit, Civitanova Marche Hospital, Local Health Authority (AST) 3, 62012 Civitanova Marche, Italy; (E.G.); (F.D.P.)
| | - Mariano Cingolani
- Department of Law, Institute of Legal Medicine, University of Macerata, 62100 Macerata, Italy;
| | - Roberto Scendoni
- Department of Law, Institute of Legal Medicine, University of Macerata, 62100 Macerata, Italy;
| | - Piergiorgio Fedeli
- School of Law, Legal Medicine, University of Camerino, 62032 Camerino, Italy;
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Gilada T, Ulrich AK, Wang Y, Lama JR, Alfaro R, Harb S, Daza G, Holte S, Pasalar S, Rios J, Ganoza C, Dasgupta S, Coombs RW, Duerr A. Viral Load Dynamics in Plasma and Semen When Antiretroviral Therapy Is Initiated During Early HIV-1 Infection. J Infect Dis 2024; 229:1141-1146. [PMID: 38073467 PMCID: PMC11011176 DOI: 10.1093/infdis/jiad520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 03/14/2024] Open
Abstract
We assessed human immunodeficiency virus (HIV) load in plasma and semen during primary HIV infection using serial samples of semen and plasma during the first 24 weeks after diagnosis in untreated participants and those who started antiretroviral therapy (ART) immediately at diagnosis. In the absence of treatment, semen viral load was >1000 copies/mL in almost all specimens (83%) collected 2-10 weeks after the estimated date of HIV acquisition and remained >1000 copies/mL in 35% of untreated participants at the last observed time point. Thus, in the absence of ART, semen viral load remained at a level consistent with transmissibility throughout primary infection.
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Affiliation(s)
| | - Angela K Ulrich
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Environmental Health Science, University of Minnesota, Minneapolis, Minnesota, USA
| | - Yixin Wang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Javier R Lama
- Asociación Civil Impacta Salud y Educación, Lima, Peru
| | - Ricardo Alfaro
- Centro de Investigaciones Tecnológicas Biomédicas y Medioambientales, Lima, Peru
| | - Socorro Harb
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Glenda Daza
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Sarah Holte
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Siavash Pasalar
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Jessica Rios
- Pharmaceutical Product Development, Inc, Lima, Peru
| | | | - Sayan Dasgupta
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Robert W Coombs
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Ann Duerr
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
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Nijhawan AE, Pulitzer Z, Torres B, Noreen N, Schultheis A, Frank C, Colon R, Brooks R, Proffitt R, Pankow J, Bennett A, Salyards M, Kuo I, Knight K, Springer SA. HIV Risk and Interest in Preexposure Prophylaxis in Justice-Involved Persons. Emerg Infect Dis 2024; 30:S68-S74. [PMID: 38561803 PMCID: PMC10986824 DOI: 10.3201/eid3013.230739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Preexposure prophylaxis (PrEP) is underused in persons who use drugs and justice-involved persons. In an ongoing randomized controlled trial in 4 US locations comparing patient navigation versus mobile health unit on time to initiation of HIV medication or PrEP for justice-involved persons who use stimulants or opioids and who are at risk for or living with HIV, we assessed HIV risk factors, perceived HIV risk, and interest in PrEP. Participants without HIV (n = 195) were 77% men, 65% White, 23% Black, and 26% Hispanic; 73% reported a recent history of condomless sex, mainly with partners of unknown HIV status. Of 34% (67/195) reporting injection drug use, 43% reported sharing equipment. Despite risk factors, many persons reported their risk for acquiring HIV as low (47%) or no (43%) risk, although 51/93 (55%) with PrEP indications reported interest in PrEP. Justice-involved persons who use drugs underestimated their HIV risk and might benefit from increased PrEP education efforts.
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Sarenje KL, van Zwetselaar M, Kumburu H, Sonda T, Mmbaga B, Ngalamika O, Maimbolwa MC, Siame A, Munsaka S, Kwenda G. Antimicrobial resistance and heterogeneity of Neisseria gonorrhoeae isolated from patients attending sexually transmitted infection clinics in Lusaka, Zambia. BMC Genomics 2024; 25:290. [PMID: 38500064 PMCID: PMC10949682 DOI: 10.1186/s12864-024-10155-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/22/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) of Neisseria gonorrhoeae is a threat to public health as strains have developed resistance to antimicrobials available for the treatment of gonorrhea. Whole genome sequencing (WGS) can detect and predict antimicrobial resistance to enhance the control and prevention of gonorrhea. Data on the molecular epidemiology of N. gonorrhoeae is sparse in Zambia. This study aimed to determine the genetic diversity of N. gonorrhoeae isolated from patients attending sexually transmitted infection (STI) clinics in Lusaka, Zambia. METHODS A cross-sectional study that sequenced 38 N. gonorrhoeae isolated from 122 patients with gonorrhea from 2019 to 2020 was conducted. The AMR profiles were determined by the E-test, and the DNA was extracted using the NucliSens easyMaG magnetic device. Whole genome sequencing was performed on the Illumina NextSeq550 platform. The Bacterial analysis pipeline (BAP) that is readily available at: https://cge.cbs.dtu.dk/services/CGEpipeline-1.1 was used for the identification of the species, assembling the genome, multi-locus sequence typing (MLST), detection of plasmids and AMR genes. Phylogeny by single nucleotide polymorphisms (SNPs) was determined with the CCphylo dataset. RESULTS The most frequent STs with 18.4% of isolates each were ST7363, ST1921 and ST1582, followed by ST1583 (13%), novel ST17026 (7.9%), ST1588 (7.9%), ST1596 (5.3%), ST11181 (5.3%), ST11750 (2.6/%) and ST11241 (2.6%) among the 38 genotyped isolates. The blaTeM-1B and tetM (55%) was the most prevalent combination of AMR genes, followed by blaTeM-1B (18.4%), tetM (15.8%), and the combination of blaTeM-1B, ermT, and tetL was 2.6% of the isolates. The AMR phenotypes were predicted in ciprofloxacin, penicillin, tetracycline, azithromycin, and cefixime. The combination of mutations 23.7% was gryA (S91F), parC (E91G), ponA (L421) and rpsJ (V57M), followed by 18.4% in gyrA (S91F), ponA (L421P), rpsJ (V57M), and 18.4% in gyrA (D95G, S91F), ponA (L421P), and rpsJ (V57M). The combinations in gyrA (D95G, S91F) and rpsJ (V57M), and gyrA (D95G, S91F), parC (E91F), ponA (L421P) and rpsJ (V57M) were 13.2% each of the isolates. Plasmid TEM-1 (84.2%), tetM (15.8%), and gonococcal genetic island (GGI) was detected in all isolates. CONCLUSION This study revealed remarkable heterogeneity of N. gonorrhoeae with blaTEM-1, tetM, ponA, gyrA, and parC genes associated with high resistance to penicillin, tetracycline, and ciprofloxacin demanding revision of the standard treatment guidelines and improved antimicrobial stewardship in Zambia.
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Affiliation(s)
- Kelvin Lutambo Sarenje
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, P.O. Box 50110, Zambia.
- Department of Dermato-venereology, University Teaching Hospital, Lusaka, Zambia.
| | | | - Happiness Kumburu
- Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Tolbert Sonda
- Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Blandina Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Owen Ngalamika
- Department of Dermato-venereology, University Teaching Hospital, Lusaka, Zambia
| | - Margaret C Maimbolwa
- Department of Midwifery Child, and Women's Health, School of Nursing Sciences, University of Zambia, Lusaka, Zambia
| | - Amon Siame
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Sody Munsaka
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, P.O. Box 50110, Zambia
| | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, P.O. Box 50110, Zambia
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Kyser AJ, Fotouh B, Mahmoud MY, Frieboes HB. Rising role of 3D-printing in delivery of therapeutics for infectious disease. J Control Release 2024; 366:349-365. [PMID: 38182058 PMCID: PMC10923108 DOI: 10.1016/j.jconrel.2023.12.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/18/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024]
Abstract
Modern drug delivery to tackle infectious disease has drawn close to personalizing medicine for specific patient populations. Challenges include antibiotic-resistant infections, healthcare associated infections, and customizing treatments for local patient populations. Recently, 3D-printing has become a facilitator for the development of personalized pharmaceutic drug delivery systems. With a variety of manufacturing techniques, 3D-printing offers advantages in drug delivery development for controlled, fine-tuned release and platforms for different routes of administration. This review summarizes 3D-printing techniques in pharmaceutics and drug delivery focusing on treating infectious diseases, and discusses the influence of 3D-printing design considerations on drug delivery platforms targeting these diseases. Additionally, applications of 3D-printing in infectious diseases are summarized, with the goal to provide insight into how future delivery innovations may benefit from 3D-printing to address the global challenges in infectious disease.
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Affiliation(s)
- Anthony J Kyser
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Bassam Fotouh
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Mohamed Y Mahmoud
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Department of Toxicology and Forensic Medicine, Faculty of Veterinary Medicine, Cairo University, Egypt.
| | - Hermann B Frieboes
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; UofL Health - Brown Cancer Center, University of Louisville, KY 40202, USA.
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6
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Zheng Y, Ye K, Ying M, He Y, Yu Q, Lan L, Xu W. Syphilis epidemic among men who have sex with men: A global systematic review and meta-analysis of prevalence, incidence, and associated factors. J Glob Health 2024; 14:04004. [PMID: 38236688 PMCID: PMC10795860 DOI: 10.7189/jogh.14.04004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024] Open
Abstract
Background We aimed to estimate the prevalence and incidence of syphilis at global, regional and national levels for human immunodeficiency virus (HIV)-positive and HIV-negative men who have sex with men (MSM) and explore the association between demographic and social behavioural factors and syphilis infection. Methods We searched PubMed, Embase, and the Cochrane Library from 1 January 2012 to 31 December 2022 for studies of reported crude syphilis prevalence or incidence in MSM or with sufficient data to calculate prevalence or incidence rate in MSM. Results We included 376 articles reporting on 409 records from 62 countries to calculate syphilis prevalence and incidence in MSM. The pooled prevalence of syphilis in MSM was 10.4%, with substantial differences between countries and regions. Syphilis prevalence was substantially higher in HIV-positive than in HIV-negative MSM. The pooled incidence of syphilis in MSM was 76.4 per 1000 person-years. Older age, lower education, nitrite or recreational drug use, group sex, and multiple sexual partners were identified as risk factors for syphilis infection. Conclusions A disproportionate geographic pattern of syphilis infection in MSM and significant threats of syphilis infection were revealed. The 'hidden risk' in specific regions and the inadequately elucidated drivers of high-risk behaviours, need to be fully acknowledged and addressed. Registration PROSPERO: CRD42023422218.
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Affiliation(s)
- Yang Zheng
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Allergy, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kangli Ye
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Meike Ying
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ying He
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qi Yu
- Department of Endodontics, Stomatology Hospital, School of Stomatology, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lei Lan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenzhi Xu
- Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Lyu Y, Choong A, Chow EPF, Seib KL, Marshall HS, Unemo M, de Voux A, Wang B, Miranda AE, Gottlieb SL, Mello MB, Wi T, Baggaley R, Marshall C, Abu-Raddad LJ, Abara WE, Chen XS, Ong JJ. Vaccine value profile for Neisseria gonorrhoeae. Vaccine 2023:S0264-410X(23)00086-5. [PMID: 38123397 DOI: 10.1016/j.vaccine.2023.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/23/2022] [Accepted: 01/23/2023] [Indexed: 12/23/2023]
Abstract
Neisseria gonorrhoeae infection (gonorrhoea) is a global public health challenge, causing substantial sexual and reproductive health consequences, such as infertility, pregnancy complications and increased acquisition or transmission of HIV. There is an urgency to controlling gonorrhoea because of increasing antimicrobial resistance to ceftriaxone, the last remaining treatment option, and the potential for gonorrhoea to become untreatable. No licensed gonococcal vaccine is available. Mounting observational evidence suggests that N. meningitidis serogroup B outer membrane vesicle-based vaccines may induce cross-protection against N. gonorrhoeae (estimated 30%-40% effectiveness using the 4CMenB vaccine). Clinical trials to determine the efficacy of the 4CMenB vaccine against N. gonorrhoeae are underway, as are Phase 1/2 studies of a new gonococcal-specific vaccine candidate. Ultimately, a gonococcal vaccine must be accessible, affordable and equitably dispensed, given that those most affected by gonorrhoea are also those who may be most disadvantaged in our societies, and most cases are in less-resourced settings. This vaccine value profile (VVP) provides a high level, holistic assessment of the current data to inform the potential public health, economic and societal value of pipeline vaccines. This was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships and multi-lateral organizations. All contributors have extensive expertise on various elements of the N. gonorrhoeae VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using published data obtained from peer-reviewed journals or reports.
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Affiliation(s)
- Yiming Lyu
- University of Melbourne, Parkville, Victoria 3010, Australia.
| | - Annabelle Choong
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne, Victoria 3004, Australia.
| | - Eric P F Chow
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne, Victoria 3004, Australia; Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Melbourne, Victoria 3053, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria 3053, Australia.
| | - Kate L Seib
- Institute for Glycomics, Griffith University, Gold Coast, Queensland 4222, Australia.
| | - Helen S Marshall
- The University of Adelaide, Adelaide, South Australia 5005, Australia; Women's and Children's Health Network, North Adelaide, South Australia, Australia.
| | - Magnus Unemo
- WHO CC for Gonorrhoea and Other STIs, Örebro University, Örebro, Sweden; Institute for Global Health, University College London (UCL), London, UK.
| | - Alex de Voux
- Division of Epidemiology and Biostatistics, Faculty of Health Sciences, University of Cape Town, Rondebosch, Cape Town 7700, South Africa.
| | - Bing Wang
- The University of Adelaide, Adelaide, South Australia 5005, Australia; Women's and Children's Health Network, North Adelaide, South Australia, Australia.
| | - Angelica E Miranda
- Department of Social Medicine, Universidade Federal do Espirito Santo, Av. Fernando Ferrari, 514 - Goiabeiras, Vitória - ES 29075-910, Brazil.
| | - Sami L Gottlieb
- Department of Sexual and Reproductive Health and Research, World Health Organization, Av. Appia 20, 1211 Genève, Switzerland.
| | - Maeve B Mello
- Global HIV, Hepatitis and STI Programmes, World Health Organization, Av. Appia 20, 1211 Genève, Switzerland.
| | - Teodora Wi
- Global HIV, Hepatitis and STI Programmes, World Health Organization, Av. Appia 20, 1211 Genève, Switzerland.
| | - Rachel Baggaley
- Global HIV, Hepatitis and STI Programmes, World Health Organization, Av. Appia 20, 1211 Genève, Switzerland.
| | - Caroline Marshall
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Av. Appia 20, 1211 Genève, Switzerland.
| | - Laith J Abu-Raddad
- Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, Box 24144, Doha, Qatar.
| | - Winston E Abara
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA.
| | - Xiang-Sheng Chen
- National Center for STD Control of China CDC, 12 Jiangwangmiao Street, Nanjing 210042, China.
| | - Jason J Ong
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne, Victoria 3004, Australia.
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Alonso D, Vallès X. A potential transition from a concentrated to a generalized HIV epidemic: the case of Madagascar. Infect Dis Poverty 2023; 12:112. [PMID: 38057918 DOI: 10.1186/s40249-023-01164-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND HIV expansion is controlled by a range of interrelated factors, including the natural history of HIV infection and socio-economical and structural factors. However, how they dynamically interact in particular contexts to drive a transition from concentrated HIV epidemics in vulnerable groups to generalized epidemics is poorly understood. We aim to explore these mechanisms, using Madagascar as a case-study. METHODS We developed a compartmental dynamic model using available data from Madagascar, a country with a contrasting concentrated epidemic, to explore the interaction between these factors with special consideration of commercial and transactional sex as HIV-infection drivers. RESULTS The model predicts sigmoidal-like prevalence curves with turning points within years 2020-2022, and prevalence reaching stabilization by 2033 within 9 to 24% in the studied (10 out of 11) cities, similar to high-prevalence regions in Southern Africa. The late/slow introduction of HIV and circumcision, a widespread traditional practice in Madagascar, could have slowed down HIV propagation, but, given the key interplay between risky behaviors associated to young women and acute infections prevalence, mediated by transactional sex, the protective effect of circumcision is currently insufficient to contain the expansion of the disease in Madagascar. CONCLUSIONS These results suggest that Madagascar may be experiencing a silent transition from a concentrated to a generalized HIV epidemic. This case-study model could help to understand how this HIV epidemic transition occurs.
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Affiliation(s)
- David Alonso
- Computational and Theoretical Ecology, Spanish Council for Scientific Research (CEAB-CSI)C, C/Access Cala Francesc, 14, 17300, Blanes, Spain
| | - Xavier Vallès
- International Health Program (PROSICS), North Metropolitan Health Area From Barcelona, Hospital Universitari Germans Trias i Pujol, Passatge dels Encants, s/n, 08914, Badalona, Catalonia, Spain.
- Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, C/Canyet s/n, 08916, Badalona, Spain.
- Fundació Lluita contra les Infeccions, C/Canyet s/n, 08916, Badalona, Spain.
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Clemente T, Lolatto R, Papaioannu Borjesson R, Fabbiani M, Manzillo E, Fronti E, Di Giambenedetto S, Gagliardini R, Rusconi S, Santoro MM, Castagna A, Spagnuolo V. Sexually transmitted infections in people with multidrug-resistant HIV. AIDS 2023; 37:2425-2430. [PMID: 37965740 DOI: 10.1097/qad.0000000000003690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Retrospective, cohort analysis including people with four-class drug-resistant HIV. Bacterial sexually transmitted infections (STIs) had an incidence of 1.3/100-person-years-of-follow-up (PYFU) in men (3.5/100-PYFU in MSM) whereas no STIs were diagnosed in women. The occurrence of STIs in this fragile population might be related to the achievement of good HIV infection control; however, given the remaining risk of virological failure and possible transmission of a multidrug-resistant virus, STI prevention counselling and HIV viremia monitoring should be prioritized.
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Affiliation(s)
- Tommaso Clemente
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan
| | - Riccardo Lolatto
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan
| | - Rebecka Papaioannu Borjesson
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan
| | - Massimiliano Fabbiani
- Department of Medical Sciences, Infectious and Tropical Diseases Unit, University Hospital of Siena, Siena
| | | | - Elisa Fronti
- Unit of Infectious Diseases, AO-Universitaria, Parma
| | - Simona Di Giambenedetto
- Department of Safety and Bioethics, Catholic University of the Sacred Heart
- Infectious Diseases Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS
| | | | - Stefano Rusconi
- Infectious Diseases Unit, Ospedale Civile di Legnano, ASST Ovest Milanese, Legnano
- DIBIC Luigi Sacco, University of Milan, Milan
| | - Maria M Santoro
- Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Antonella Castagna
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan
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10
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Beck EJ, Laeyendecker O, Saraf S, Ashokkumar S, Onzia A, Melendez JH, Chan J, Kyambadde P, Gough E, Parkes-Ratanshi R, Manabe YC, Hamill MM. High level of HIV viral suppression in a cross-sectional study of Ugandan men with urethritis and bacterial STI. Int J STD AIDS 2023; 34:998-1003. [PMID: 37544771 DOI: 10.1177/09564624231193491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
BACKGROUND Urethritis associated with non-viral sexually transmitted infections (STI) increases the risk of HIV acquisition and transmission in those living with HIV (LWH) without viral load suppression (VLS). Compared to women, men typically have lower rates of HIV VLS. We assessed the prevalence of VLS and drug resistance mutations in men LWH and urethral discharge syndrome (UDS) in Kampala, Uganda. METHODS Men with UDS were recruited in Kampala October 2019-November 2020. Medical, demographic, and behavioural data were collected with biological samples. All reactive HIV results (rapid, sequential algorithm) underwent confirmatory HIV antibody- and HIV incidence-testing, and viral load (VL) measurement. The pol and gp41 regions were sequenced on samples with VLs >1000 cpm, phylogenetic trees were generated, and resistance mutations were investigated. RESULTS 50 of 250 participants (20%) had reactive HIV rapid tests and 48/50 (96%) were aware of their HIV status and using antiretroviral therapy (ART). The median age was 38 years (IQR 32-45), 27/50 (54%) had engaged in transactional sex, and 30/50 (60%) reported alcohol before sex. VLS was present in 46/50 (92%). There were no major resistance mutations present in any samples analyzed. CONCLUSIONS The prevalence of HIV and VLS was greater in these men than in the general Ugandan adult population. Most men LWH were on ART and thus less likely to transmit HIV despite demonstrating sexual behaviours associated with high-risk of STIs. These data emphasize that high levels of ART coverage and VLS are achievable among men with UDS in urban Kampala.
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Affiliation(s)
- Evan J Beck
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sharada Saraf
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Swetha Ashokkumar
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Annet Onzia
- Infectious Disease Institute, Makerere University, Kampala, Uganda
| | - Johan H Melendez
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Justin Chan
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Peter Kyambadde
- STD and AIDS Control Programme, Ministry of Health of Uganda, Kampala, Uganda
| | - Ethan Gough
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Yukari C Manabe
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Infectious Disease Institute, Makerere University, Kampala, Uganda
| | - Matthew M Hamill
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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11
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Munishi CG, Njiro BJ, Ndumwa HP, Myemba DT, Mang'ombe E, Bwire GM. The risk of HIV transmission based on viral load in serodiscordant heterosexual partners receiving antiretroviral therapy: An umbrella review. J Evid Based Med 2023; 16:438-441. [PMID: 38058276 DOI: 10.1111/jebm.12564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Castory G Munishi
- Department of Pharmaceutics and Pharmacy Practice, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Belinda J Njiro
- Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Harrieth P Ndumwa
- Department of Community Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - David T Myemba
- Department of Pharmaceutics and Pharmacy Practice, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Emmanuel Mang'ombe
- Department of Microbiology and Parasitology, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
| | - George M Bwire
- Department of Pharmaceutical Microbiology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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12
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Reisner SL, Deutsch MB, Mayer KH, Pletta DR, Campbell J, Potter J, Keuroghlian AS, Hughto JMW, Asquith A, Pardee DJ, Harris A, Quint M, Grasso C, Gonzalez A, Radix A. Decreased Anogenital Gonorrhea and Chlamydia in Transgender and Gender Diverse Primary Care Patients Receiving Gender-Affirming Hormone Therapy. J Gen Intern Med 2023:10.1007/s11606-023-08531-7. [PMID: 37989820 DOI: 10.1007/s11606-023-08531-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Transgender and gender diverse (TGD) adults in the U.S. experience health disparities, including in anogenital sexually transmitted infections (STI). Gender-affirming hormone therapy (GAHT) is known to be medically necessary and improve health. Few studies have assessed the effect of GAHT on STI diagnoses. OBJECTIVE To evaluate the effect of GAHT delivered in primary care as an intervention to improve STI outcomes for TGD adults. DESIGN LEGACY is a longitudinal, multisite cohort study of adult TGD primary care patients from two federally qualified community health centers in Boston, MA, and New York, NY. PARTICIPANTS Electronic health record data for eligible adult TGD patients contributed to the LEGACY research data warehouse (RDW). A total of 6330 LEGACY RDW patients were followed from 2016 to 2019, with 2555 patients providing STI testing data. MAIN MEASURES GAHT exposure was being prescribed hormones, and the clinical outcome was anogenital gonorrhea or chlamydia diagnoses. Log-Poisson generalized estimating equations assessed the effect of prescription GAHT on primary outcomes, adjusting for age, race, ethnicity, gender identity, poverty level, health insurance, clinical site, and cohort years. KEY RESULTS The median age was 28 years (IQR = 13); the racial breakdown was 20.4% Black, 8.1% Multiracial, 6.9% Asian/Pacific Islander, 1.8% Other; 62.8% White; 21.3% Hispanic/Latinx; 47.0% were assigned female at birth, and 16.0% identified as nonbinary. 86.3% were prescribed hormones. Among those tested, the percentage of patients with a positive anogenital STI diagnosis ranged annually from 10.0 to 12.5% between 2016 and 2019. GAHT prescription was associated with a significant reduction in the risk of anogenital STI diagnosis (aRR = 0.75; 95% CI = 0.59-0.96) over follow-up. CONCLUSIONS GAHT delivered in primary care was associated with less STI morbidity in this TGD cohort over follow-up. Patients may benefit from individualized and tailored clinical care alongside GAHT to optimize STI outcomes.
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Affiliation(s)
- Sari L Reisner
- Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- The Fenway Institute, Fenway Health, Boston, MA, USA.
| | | | - Kenneth H Mayer
- Harvard Medical School, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - David R Pletta
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | | | - Jennifer Potter
- Harvard Medical School, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Alex S Keuroghlian
- Harvard Medical School, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Massachusetts General Hospital, Boston, MA, USA
| | - Jaclyn M W Hughto
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Brown University School of Public Health, Providence, RI, USA
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA
| | | | - Dana J Pardee
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | | | - Meg Quint
- Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, USA
| | - Chris Grasso
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Alex Gonzalez
- Harvard Medical School, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Asa Radix
- Callen-Lorde Community Health Center, New York, NY, USA
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13
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Allan-Blitz LT, Shah P, Adams G, Branda JA, Klausner JD, Goldstein R, Sabeti PC, Lemieux JE. Development of Cas13a-based assays for Neisseria gonorrhoeae detection and gyrase A determination. mSphere 2023; 8:e0041623. [PMID: 37732792 PMCID: PMC10597441 DOI: 10.1128/msphere.00416-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 09/22/2023] Open
Abstract
Neisseria gonorrhoeae is one of the most common bacterial sexually transmitted infections. The emergence of antimicrobial-resistant N. gonorrhoeae is an urgent public health threat. Currently, the diagnosis of N. gonorrhoeae infection requires expensive laboratory infrastructure, while antimicrobial susceptibility determination requires bacterial culture, both of which are infeasible in low-resource areas where the prevalence of infection is highest. Recent advances in molecular diagnostics, such as specific high-sensitivity enzymatic reporter unlocking (SHERLOCK) using CRISPR-Cas13a and isothermal amplification, have the potential to provide low-cost detection of pathogen and antimicrobial resistance. We designed and optimized RNA guides and primer sets for SHERLOCK assays capable of detecting N. gonorrhoeae via the porA gene and of predicting ciprofloxacin susceptibility via a single mutation in the gyrase A (gyrA) gene. We evaluated their performance using both synthetic DNA and purified N. gonorrhoeae isolates. For porA, we created both a fluorescence-based assay and lateral flow assay using a biotinylated fluorescein reporter. Both methods demonstrated sensitive detection of 14 N. gonorrhoeae isolates and no cross-reactivity with 3 non-gonococcal Neisseria isolates. For gyrA, we created a fluorescence-based assay that correctly distinguished between 20 purified N. gonorrhoeae isolates with phenotypic ciprofloxacin resistance and 3 with phenotypic susceptibility. We confirmed the gyrA genotype predictions from the fluorescence-based assay with DNA sequencing, which showed 100% concordance for the isolates studied. We report the development of Cas13a-based SHERLOCK assays that detect N. gonorrhoeae and differentiate ciprofloxacin-resistant isolates from ciprofloxacin-susceptible isolates. IMPORTANCE Neisseria gonorrhoeae, the cause of gonorrhea, disproportionately affects resource-limited settings. Such areas, however, lack the technical capabilities for diagnosing the infection. The consequences of poor or absent diagnostics include increased disease morbidity, which, for gonorrhea, includes an increased risk for HIV infection, infertility, and neonatal blindness, as well as an overuse of antibiotics that contributes to the emergence of antibiotic resistance. We used a novel CRISPR-based technology to develop a rapid test that does not require laboratory infrastructure for both diagnosing gonorrhea and predicting whether ciprofloxacin can be used in its treatment, a one-time oral pill. With further development, that diagnostic test may be of use in low-resource settings.
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Affiliation(s)
- Lao-Tzu Allan-Blitz
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Palak Shah
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Gordon Adams
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - John A. Branda
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jeffrey D. Klausner
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Robert Goldstein
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Pardis C. Sabeti
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, Massachusetts, USA
| | - Jacob E. Lemieux
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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14
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Malefo MA, Ayo-Yusuf O, Mokgatle MM. Risk factors for sexually transmitted infections among men who have sex with men. Afr J Prim Health Care Fam Med 2023; 15:e1-e7. [PMID: 37916720 PMCID: PMC10623483 DOI: 10.4102/phcfm.v15i1.4080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) are a global public health concern and sub-Saharan Africa, has limited data on STIs in the men who have sex with men (MSM) population. Syndromic management has controversies for treating asymptomatic STIs (ASTIs). AIM The aim of this study was to describe the risk factors for STIs among MSM. SETTING This study was conducted in Tshwane North, Gauteng Province in South Africa. METHODS A cross-sectional quantitative design was employed using structured questionnaires, rapid plasma reagent test, from December 2021 to May 2022. Bivariate and multivariate analyses were used for statistical analysis. RESULTS A total of 200 MSM with the mean age of 27.6, standard deviations: 6.8 participated, and STIs prevalence was 66%, with 37% concurrent infections. Ureaplasma urealyticum was (24%), Mycoplasma hominis (23%), Chlamydia trachomatis (20%), Treponema pallidum (20%) and Neisseria gonorrhoeae (9%). The risk factors for acquisition of STI include having a new partner in the last month (OR = 1.68; CI: 0.98-3.13). CONCLUSION The prevalence of ASTIs is high. Serial and multiple sexual partners are the risk factors.Contribution: This study contributes to the body of knowledge of the burden of STIs among high-risk population.
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Affiliation(s)
- Matshidiso A Malefo
- School of Health Care Sciences, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria.
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15
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Hou J, Fu R, Jiang T, Yu NX. Common Dyadic Coping Mediates the Associations Between We-Disease Appraisal and Relationship Satisfaction and Quality of Life in HIV Serodiscordant Couples: The Common Fate Mediation Model. Ann Behav Med 2023; 57:978-987. [PMID: 37435876 DOI: 10.1093/abm/kaad036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Since HIV has evolved into a lifelong but manageable condition, improving the quality of life (QoL) of persons living with HIV (PLWHs) has become increasingly important. Living with HIV is life-altering and poses substantial challenges for both PLWHs and their partners, so identifying how HIV serodiscordant couples cope with HIV together is crucial. Here, Bodenmann's Systemic Transaction Model highlights common dyadic coping (CDC), which refers to both partners working together to alleviate the negative effects of stress. PURPOSE We examined the mediating role of CDC in linking we-disease appraisal with relationship satisfaction and QoL. METHODS We recruited a convenience sample of 231 HIV serodiscordant couples via local grassroots organizations between June and October 2022. Participants completed measures of we-disease appraisal, CDC, relationship satisfaction, and QoL. We examined the mediation effect of CDC on the association between we-disease appraisal and outcomes using the common fate mediation model. RESULTS The mean age of PLWHs was 32.18 years (standard deviation = 8.61 years), and that of their partners was 32.55 years (standard deviation = 9.24 years). The average time since HIV diagnosis was 4.18 years. Most couples were same-sex male couples. We found that CDC mediated the effect of we-disease appraisal on relationship satisfaction. Moreover, CDC significantly mediated the effect of we-disease appraisal on the QoL of PLWHs and their partners. CONCLUSIONS Our findings highlight the importance of CDC in dyadic illness management among Chinese HIV serodiscordant couples.
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Affiliation(s)
- Jianhua Hou
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, P. R. China
| | - Rong Fu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, P. R. China
| | - Taiyi Jiang
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, P. R. China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, P. R. China
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16
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Peck ME, Bronson M, Djomand G, Basile I, Collins K, Kankindi I, Kayirangwa E, Malamba SS, Mugisha V, Nsanzimana S, Remera E, Kazaura KJ, Amuri M, Mmbando S, Mgomella GS, Simbeye D, Colletar Awor A, Biraro S, Kabuye G, Kirungi W, Chituwo O, Hanunka B, Kamboyi R, Mulenga L, Musonda B, Muyunda B, Nkumbula T, Malaba R, Mandisarisa J, Musuka G, Peterson AE, Toledo C. HIV, syphilis, and hepatitis B virus infection and male circumcision in five Sub-Saharan African countries: Findings from the Population-based HIV Impact Assessment surveys, 2015-2019. PLOS Glob Public Health 2023; 3:e0002326. [PMID: 37721926 PMCID: PMC10506706 DOI: 10.1371/journal.pgph.0002326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/06/2023] [Indexed: 09/20/2023]
Abstract
Voluntary medical male circumcision (VMMC) has primarily been promoted for HIV prevention. Evidence also supports that male circumcision offers protection against other sexually transmitted infections. This analysis assessed the effect of circumcision on syphilis, hepatitis B virus (HBV) infection and HIV. Data from the 2015 to 2019 Population-based HIV Impact Assessments (PHIAs) surveys from Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe were used for the analysis. The PHIA surveys are cross-sectional, nationally representative household surveys that include biomarking testing for HIV, syphilis and HBV infection. This is a secondary data analysis using publicly available PHIA data. Univariate and multivariable logistic regression models were created using pooled PHIA data across the five countries to assess the effect of male circumcision on HIV, active and ever syphilis, and HBV infection among sexually active males aged 15-59 years. Circumcised men had lower odds of syphilis infection, ever or active infection, and HIV, compared to uncircumcised men, after adjusting for covariates (active syphilis infection = 0.67 adjusted odds ratio (aOR), 95% confidence interval (CI), 0.52-0.87, ever having had a syphilis infection = 0.85 aOR, 95% CI, 0.73-0.98, and HIV = 0.53 aOR, 95% CI, 0.47-0.61). No difference between circumcised and uncircumcised men was identified for HBV infection (P = 0.75). Circumcised men have a reduced likelihood for syphilis and HIV compared to uncircumcised men. However, we found no statistically significant difference between circumcised and uncircumcised men for HBV infection.
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Affiliation(s)
- Megan E. Peck
- Division of Global HIV & TB, HIV Prevention Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Megan Bronson
- Division of Global HIV & TB, Epidemiology and Surveillance Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Gaston Djomand
- Division of Global HIV & TB, HIV Prevention Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Ikuzo Basile
- Ministry of Health, Rwanda Biomedical Center, Kigali City, Rwanda
| | | | - Ida Kankindi
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Kigali, Rwanda
| | - Eugenie Kayirangwa
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Kigali, Rwanda
| | - Samuel S. Malamba
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Kigali, Rwanda
| | | | - Sabin Nsanzimana
- Ministry of Health, Rwanda Biomedical Center, Kigali City, Rwanda
| | - Eric Remera
- Ministry of Health, Rwanda Biomedical Center, Kigali City, Rwanda
| | - Kokuhumbya J. Kazaura
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Dar-es-Salaam, Tanzania
| | - Mbaraka Amuri
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Dar-es-Salaam, Tanzania
| | - Susan Mmbando
- National AIDS Control Program, Ministry of Health, Dar-es-Salaam, Tanzania
| | - George S. Mgomella
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Dar-es-Salaam, Tanzania
| | - Daimon Simbeye
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Dar-es-Salaam, Tanzania
| | - Anna Colletar Awor
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Kampala, Uganda
| | | | - Geoffrey Kabuye
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Kampala, Uganda
| | | | - Omega Chituwo
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Brave Hanunka
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Royd Kamboyi
- Department of Public Health, Ministry of Health, Lusaka, Zambia
| | - Lloyd Mulenga
- Department of Public Health, Ministry of Health, Lusaka, Zambia
| | - Bupe Musonda
- Department of Public Health, Ministry of Health, Lusaka, Zambia
| | - Brian Muyunda
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | | | - Rickie Malaba
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Harare, Zimbabwe
| | - John Mandisarisa
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Harare, Zimbabwe
| | | | - Amy E. Peterson
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Harare, Zimbabwe
| | - Carlos Toledo
- Division of Global HIV & TB, HIV Prevention Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America
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17
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Young LE. Effects of Online Friendships on Safer Sex Communication and Behavior among Black Sexual Minority Men: A Study of Network Exposure. Health Commun 2023:1-12. [PMID: 37712151 PMCID: PMC10940198 DOI: 10.1080/10410236.2023.2258309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
This study draws on social normative and social learning theories to examine the masspersonal safer sex communication (i.e., Facebook posts about safer sex) and safer sex behavior (i.e., condom use) in a cohort of Black sexual minority men (BSMM) (N = 340), with an eye toward understanding their relationship with the safer sex communication and behaviors of their BSMM Facebook friends. Using linear network autocorrelation regression models, results showed that BSMM's safer sex communication and condom use behavior were each associated with the communication and behavior of their online peers. Specifically, BSMM's condom use was positively associated with their friends' condom use and friends' safer sex communication, and BSMMs' safer sex communication was positively associated with friends' safer sex communication. Moreover, contrary to prior research, BSSM's safer sex communication and condom use were not related to one another, suggesting that talking about safer sex on social media should not be interpreted to be an indication of engageDment in safer sex behavior. These findings underscore an opportunity to leverage peer influence in social media networks, particularly in the form of masspersonal communication, to encourage cascades of safer sex messaging among peers and adoption of safer sex behavior.
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Affiliation(s)
- Lindsay E Young
- University of Southern California, Annenberg School for Communication and Journalism
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18
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Reis RK, Antonini M, Milanês Sousa LR, Rocha KADA, Naiff Ferreira GRO, Vettore MV, Gir E. Amplified HIV Transmission Risk Among People Living With HIV in Southeast Brazil. J Assoc Nurses AIDS Care 2023; 34:469-480. [PMID: 37565984 PMCID: PMC10470434 DOI: 10.1097/jnc.0000000000000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
ABSTRACT This study investigated the factors associated with amplified HIV transmission risk among people living with HIV from a city in southeast Brazil. A cross-sectional study was conducted with 397 people living with HIV recruited in infectious diseases clinics. Data on risk of HIV transmission, sociodemographic characteristics, sexual behaviors, professional counseling, serological HIV status, HIV-related clinical data, and beliefs about risk of HIV transmission were collected through interviews and medical records. Hierarchical ordered multinomial regression analyses were performed. Amplified HIV risk transmission was associated with lower age, alcohol consumption before having sex, illicit drug use before sexual intercourse, and not receiving professional counseling about HIV transmission. The belief that HIV can be transmitted to a partner not living with HIV was associated with lower likelihood of amplified risk for HIV transmission. Our findings suggest the importance of minimizing substance use before having sex, professional counseling, and beliefs about HIV transmission on amplified HIV risk transmission.
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Affiliation(s)
- Renata Karina Reis
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Marcela Antonini
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Laelson Rochelle Milanês Sousa
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Karyanna Alves de Alencar Rocha
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Glenda Roberta Oliveira Naiff Ferreira
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Mario Vianna Vettore
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Elucir Gir
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
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Fischer B, Jaoko W, Kirui E, Muture B, Madegwa I, Kageni L. Dyspareunia, signs of epithelial disruption, sexual abstinence, and HIV status in female sex workers in Nairobi: a cross-sectional study. BMC Infect Dis 2023; 23:569. [PMID: 37658320 PMCID: PMC10472738 DOI: 10.1186/s12879-023-08572-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/28/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Epithelial trauma is a risk factor of HIV infection in men who have sex with men (MSM) and female sex workers (FSWs). Painful intercourse may be indicative of epithelial tissue disruption. Previous studies on a cohort of Kenyan FSWs established an association between prolonged sexual abstinence and late HIV seroconversion. Our research objective was to establish whether there is a relationship between HIV serostatus and signs of epithelial disruption and between HIV serostatus and sexual abstinence behaviour. METHODS Participants were selected from a Nairobi health facility. A structured questionnaire was administered to 322 FSWs, who provided data on HIV status, sexual behaviour, abstinence intervals and the level of sexual dysfunction. Sexual dysfunction scores were created using parts of the Female Sexual Function Index (FSFI-19). Additional questions addressed epithelial trauma signs. Descriptive data analysis, bivariate and multivariate logistic regression were used to describe the study population and determine factors associated with living with HIV. Potential factors influencing sexual dysfunction were assessed by FSWs via self-rating. RESULTS 36% of FSWs reported discomfort or pain during vaginal penetration half the time. 44% noticed genital bleeding half the time. Vaginal tenderness was experienced by 70.6% half the time during or after intercourse. Variables predictive of living with HIV on multivariate analysis included a medium and high score of discomfort or pain during and following vaginal penetration (medium: AOR 2.288, p-value 0.032, 95% CI 1.075-4.871; high: AOR 3.044, p-value 0.031, 95% CI 1.110-8.348). No significant association of HIV status with past abstinence durations as reported by participants could be established in the multivariate analysis. A majority of FSWs agreed that steady partnerships (81% agreement), regularity of intercourse (74%), foreplay (72%) and lubricants (65%) alleviated dyspareunia. CONCLUSIONS Recurrent exposure to blood during sex was highly prevalent in FSWs, as was sexual dysfunction. Complaint levels were associated with living with HIV, providing evidence that reducing sexual dysfunctions may prevent HIV transmission. Preventive initiatives may be created that address sexual dysfunction in key populations and general populations with a high HIV prevalence. Subjective assessments indicate that prevention may include the promotion of sexual intercourse regularity, foreplay, and lubricant use.
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Affiliation(s)
- Bastian Fischer
- Department of Psychiatry and Psychotherapy, Hubertusburg Hospital Wermsdorf, Husarenpark 5, 04860, Torgau, Germany.
| | - Walter Jaoko
- KAVI-Institute of Clinical Research College of Health Sciences, University of Nairobi, 3rd Floor Wing B, P.O. Box 19676 - 00202, Nairobi, Kenya
| | - Elvis Kirui
- Independent scholar, P.O. Box 30197-00100, Nairobi, Kenya
| | - Bernard Muture
- Independent scholar, P.O. Box 30197-00100, Nairobi, Kenya
| | - Isaac Madegwa
- KAVI-Institute of Clinical Research College of Health Sciences, University of Nairobi, 3rd Floor Wing B, P.O. Box 19676 - 00202, Nairobi, Kenya
| | - Lisbeth Kageni
- KAVI-Institute of Clinical Research College of Health Sciences, University of Nairobi, 3rd Floor Wing B, P.O. Box 19676 - 00202, Nairobi, Kenya
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Schuetz A, Corley MJ, Sacdalan C, Phuang-Ngern Y, Nakpor T, Wansom T, Ehrenberg PK, Sriplienchan S, Thomas R, Ratnaratorn N, Sukhumvittaya S, Tragonlugsana N, Slike BM, Akapirat S, Pinyakorn S, Rerknimitr R, Pang AP, Kroon E, Teeratakulpisan N, Krebs SJ, Phanuphak N, Ndhlovu LC, Vasan S. Distinct mucosal and systemic immunological characteristics in transgender women potentially relating to HIV acquisition. JCI Insight 2023; 8:e169272. [PMID: 37432754 PMCID: PMC10543719 DOI: 10.1172/jci.insight.169272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/06/2023] [Indexed: 07/12/2023] Open
Abstract
Transgender women (TGW) are disproportionally affected by HIV infection, with a global estimated prevalence of 19.9%, often attributed to behavioral risk factors, with less known about biological factors. We evaluated potential biological risk factors for HIV acquisition in TGW at the sites of viral entry by assessing immune parameters of the neovaginal surface and gut mucosa. The neovagina in TGW, compared with the vagina in cisgender women (CW), shows distinct cell composition and may pose a more inflammatory environment, evidenced by increased CD4+ T cell activation and higher levels of soluble markers of inflammation (C-reactive protein, soluble CD30). Increased inflammation may be driven by microbiome composition, as shown by a greater abundance of Prevotella and a higher Shannon Diversity Index. In addition, we have observed higher frequency of CD4+CCR5+ target cells and decreased DNA methylation of the CCR5 gene in the gut mucosa of TGW compared with CW and men who have sex with men, which was inversely correlated with testosterone levels. The rectal microbiome composition in TGW appears to favor a proinflammatory milieu as well as mucosal barrier disruption. Thus, it is possible that increased inflammation and higher frequencies of CCR5-expressing target cells at sites of mucosal viral entry may contribute to increased risk of HIV acquisition in TGW, with further validation in larger studies warranted.
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Affiliation(s)
- Alexandra Schuetz
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
| | - Michael J. Corley
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | | | | | | | - Tanyaporn Wansom
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
| | - Philip K. Ehrenberg
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | | | - Rasmi Thomas
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | | | | | | | - Bonnie M. Slike
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
| | - Siriwat Akapirat
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Suteeraporn Pinyakorn
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
| | - Rungsun Rerknimitr
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Alina P.S. Pang
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Eugène Kroon
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | | | - Shelly J. Krebs
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
| | | | - Lishomwa C. Ndhlovu
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Sandhya Vasan
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
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Pilligua-Lucas M, Tkavc R, Bash SK, North BB, Weitzel MB, Jerse AE. Polyphenylene carboxymethylene (PPCM), the active component of the topical contraceptive Yaso-GEL, exhibits potent antimicrobial activity against Neisseria gonorrhoeae in preclinical studies. Sex Transm Infect 2023; 99:409-415. [PMID: 37156608 PMCID: PMC10447406 DOI: 10.1136/sextrans-2022-055596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/07/2023] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION Polyphenylene carboxymethylene (PPCM) is a condensation polymer that has both contraceptive and antimicrobial activity against several sexually transmitted viruses including HIV, herpes simplex virus, Ebola virus and SARS-CoV-2 in preclinical studies. PPCM, both as an active pharmaceutical ingredient (API) and in a vaginal gel formulation (Yaso-GEL), has an excellent safety profile. Here, we evaluated the efficacy of PPCM against Neisseria gonorrhoeae in vitro and in a gonorrhoea mouse model. METHODS The minimal inhibitory concentration (MIC) of PPCM was determined against 11 N. gonorrhoeae strains by agar dilution and a microtitre plate-based method. In vivo efficacy was tested in a murine model of N. gonorrhoeae genital tract infection by applying Yaso-GEL, PPCM incorporated in 2.7% hydroxyethylcellulose (HEC), or the HEC vehicle vaginally prior to challenge with N. gonorrhoeae. Vaginal swabs were quantitatively cultured over 5 days to assess efficacy. RESULTS PPCM MIC against N. gonorrhoeae ranged between 5-100 µg/mL (agar dilution) and 50-200 µg/mL (microtitre plate method). PPCM/HEC gel applied vaginally prior to bacterial challenge resulted in a concentration-dependent inhibition of infection. Yaso-GEL containing 4% PPCM prevented infection in 100% of mice. Incubation of N. gonorrhoeae with PPCM increased membrane permeability, suggesting PPCM directly compromises N. gonorrhoeae viability, which may be a mechanism by which PPCM inhibits N. gonorrhoeae infection. CONCLUSIONS Yaso-GEL containing the API PPCM showed significant activity against N. gonorrhoeae in vitro and in vivo in a female mouse model. These data support further development of Yaso-GEL as an inexpensive, non-hormonal and non-systemic product with both contraceptive and antimicrobial activity against gonorrhea and other common sexually transmitted infections (STIs). Such multipurpose prevention technology products are needed by women in all economic, social and cultural circumstances to prevent unintended pregnancy and STIs.
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Affiliation(s)
- Michelle Pilligua-Lucas
- Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, Maryland, USA
| | - Rok Tkavc
- Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, Maryland, USA
| | - Sarah K Bash
- Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, Maryland, USA
| | | | | | - Ann E Jerse
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, Maryland, USA
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Aseeri IA, AlOtaibi MN, Alzahrani WJ, Althomali MA, Alattar HA, Althobity AF. Public Awareness About Sexually Transmitted Diseases in Taif, Saudi Arabia. Cureus 2023; 15:e42302. [PMID: 37609085 PMCID: PMC10441818 DOI: 10.7759/cureus.42302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 08/24/2023] Open
Abstract
INTRODUCTION Islamic culture does not tolerate homosexuality and extramarital sex. This may result in ignorance of safe sex practices and a lack of proper public health education by the authorities and parents; this includes knowledge and awareness about sexually transmitted diseases (STDs), modes of transmission, protection methods, and sources of information about STDs. METHODS This is a cross-sectional study, a Quick Response (QR)-code-based survey. A standard web-based questionnaire was electronically delivered to our enlisted sample. The statistical analysis started by transferring data from the Excel spreadsheet (Microsoft Corporation, Redmond, Washington, United States) to the SPSS software program. We used one-way ANOVA to compare mean scores between the various groups. And we used the Pearson correlation coefficient to assess the association of age with the score. Significance was established at a p-value of 0.05 or less with a 95% confidence interval. All statistical calculations were performed using IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States). RESULTS The study analysed the sociodemographic characteristics and STD knowledge of 608 participants. Findings revealed a balanced gender distribution, 52.8% male and 47.2% female, the majority being single (72.0%) and with a university education (72.0%). Knowledge gaps were identified, such as confusion between genital herpes and HIV, limited understanding of chlamydia transmission, and misconceptions about human papillomavirus (HPV) and HIV. No significant differences were found based on sex, age, marital status, or father's education. However, higher education of mother correlated with significantly higher knowledge scores (p < 0.0001). CONCLUSION This study shed light on the limited knowledge and misconceptions surrounding STDs in Taif city. The findings highlighted knowledge gaps, including confusion between different STDs and misconceptions about transmission modes. The results revealed a positive correlation between higher maternal education and increased knowledge scores. These findings underscore the urgency for health authorities to develop awareness campaigns and educational initiatives to promote accurate information and foster healthier attitudes toward sexual activity in these regions.
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Affiliation(s)
- Ibrahim A Aseeri
- Faculty of Medicine, Taif University - College of Medicine, Taif, SAU
| | | | | | | | - Hattan A Alattar
- Faculty of Medicine, Taif University - College of Medicine, Taif, SAU
| | - Ahmed F Althobity
- Department of Surgery, Taif University - College of Medicine, Taif, SAU
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23
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Allan-Blitz LT, Shah P, Adams G, Branda JA, Klausner JD, Goldstein R, Sabeti PC, Lemieux JE. Development of Cas13a-based Assays for Neisseria gonorrhoeae Detection and Gyrase A Determination. medRxiv 2023:2023.05.21.23290304. [PMID: 37293004 PMCID: PMC10246164 DOI: 10.1101/2023.05.21.23290304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Neisseria gonorrhoeae is one of the most common bacterial sexually transmitted infections. The emergence of antimicrobial-resistant N. gonorrhoeae is an urgent public health threat. Currently, diagnosis of N. gonorrhoeae infection requires expensive laboratory infrastructure, while antimicrobial susceptibility determination requires bacterial culture, both of which are infeasible in low-resource areas where prevalence is highest. Recent advances in molecular diagnostics, such as Specific High-sensitivity Enzymatic Reporter unLOCKing (SHERLOCK) using CRISPR-Cas13a and isothermal amplification, have the potential to provide low-cost detection of pathogen and antimicrobial resistance. Methods and Results We designed and optimized RNA guides and primer-sets for SHERLOCK assays capable of detecting N. gonorrhoeae via the por A gene and of predicting ciprofloxacin susceptibility via a single mutation in the gyrase A ( gyr A) gene. We evaluated their performance using both synthetic DNA and purified N. gonorrhoeae isolates. For por A, we created both a fluorescence-based assay and lateral flow assay using a biotinylated FAM reporter. Both methods demonstrated sensitive detection of 14 N. gonorrhoeae isolates and no cross-reactivity with 3 non-gonococcal Neisseria isolates. For gyr A, we created a fluorescence-based assay that correctly distinguished between 20 purified N. gonorrhoeae isolates with phenotypic ciprofloxacin resistance and 3 with phenotypic susceptibility. We confirmed the gyr A genotype predictions from the fluorescence-based assay with DNA sequencing, which showed 100% concordance for the isolates studied. Conclusion We report the development of Cas13a-based SHERLOCK assays that detect N. gonorrhoeae and differentiate ciprofloxacin-resistant isolates from ciprofloxacin-susceptible isolates.
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Affiliation(s)
- Lao-Tzu Allan-Blitz
- Division of Global Health Equity: Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, MA
- Division of Infectious Diseases: Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Palak Shah
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, MA
- Division of Infectious Diseases: Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Gordon Adams
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, MA
- Division of Infectious Diseases: Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - John A. Branda
- Department of Pathology, Massachusetts General Hospital, Boston, MA
| | - Jeffrey D. Klausner
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Robert Goldstein
- Division of Infectious Diseases: Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Pardis C. Sabeti
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, MA
| | - Jacob E. Lemieux
- Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, MA
- Division of Infectious Diseases: Department of Medicine, Massachusetts General Hospital, Boston, MA
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Vujcich D, Roberts M, Selway T, Nattabi B. The Application of Systems Thinking to the Prevention and Control of Sexually Transmissible Infections among Adolescents and Adults: A Scoping Review. Int J Environ Res Public Health 2023; 20:ijerph20095708. [PMID: 37174226 PMCID: PMC10178699 DOI: 10.3390/ijerph20095708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/20/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
Systems thinking is a mechanism for making sense of complex systems that challenge linear explanations of cause-and-effect. While the prevention and control of sexually transmissible infections (STIs) has been identified as an area that may benefit from systems-level analyses, no review on the subject currently exists. The aim of this study is to conduct a scoping review to identify literature in which systems thinking has been applied to the prevention and control of STIs among adolescent and adult populations. Joanna Briggs Institute guidelines for the conduct of scoping reviews were followed. Five databases were searched for English-language studies published after 2011. A total of n = 6102 studies were screened against inclusion criteria and n = 70 were included in the review. The majority of studies (n = 34) were conducted in African nations. Few studies focused on priority sub-populations, and 93% were focused on HIV (n = 65). The most commonly applied systems thinking method was system dynamics modelling (n = 28). The review highlights areas for future research, including the need for more STI systems thinking studies focused on: (1) migrant and Indigenous populations; (2) conditions such as syphilis; and (3) innovations such as pre-exposure prophylaxis and at-home testing for HIV. The need for conceptual clarity around 'systems thinking' is also highlighted.
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Affiliation(s)
- Daniel Vujcich
- Western Australian Sexual Health and Blood-Borne Virus Applied Research and Evaluation Network, School of Population Health, Curtin University, Perth, WA 6102, Australia
| | - Meagan Roberts
- Western Australian Sexual Health and Blood-Borne Virus Applied Research and Evaluation Network, School of Population Health, Curtin University, Perth, WA 6102, Australia
| | - Tyler Selway
- Western Australian Sexual Health and Blood-Borne Virus Applied Research and Evaluation Network, School of Population Health, Curtin University, Perth, WA 6102, Australia
| | - Barbara Nattabi
- School of Population and Global Health, University of Western Australia, Perth, WA 6009, Australia
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Blair CS, Fulcher JA, Cho GD, Gorbach PM, Shoptaw S, Clark JL. Brief Report: Impact of Methamphetamine Use and Rectal STIs on Systemic and Rectal Mucosal Inflammation. J Acquir Immune Defic Syndr 2023; 92:281-285. [PMID: 36515912 PMCID: PMC9974870 DOI: 10.1097/qai.0000000000003143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Methamphetamine (MA) use is associated with sexual risk behavior as well as systemic and mucosal inflammation, suggesting parallel biological and behavioral mechanisms of HIV transmission among men who have sex with men (MSM) who use MA. Data evaluating the combined biological effects of MA use with concomitant rectal gonococcal and/or chlamydial (GC/CT) infection on inflammation are limited. SETTING Secondary analysis of stored rectal and plasma specimens from 100 MSM participating in an NIDA-funded longitudinal cohort in Los Angeles, CA. METHODS This cross-sectional analysis evaluated systemic and rectal inflammatory markers under 2 conditions: (1) recent MA use (by urine drug screen) and (2) rectal GC/CT infection. We evaluated 50 participants with recent MA use (25 with and 25 without rectal GC/CT) and 50 MSM without MA use (25 with and 25 without rectal GC/CT). Log-transformed plasma and rectal immune markers were regressed on MA exposure and rectal GC/CT, controlling for HIV status and age. RESULTS Median age was 32 (range 19-45) years, and 58% of participants were living with HIV. Plasma tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-1ß, and rectal IL-6 were associated with rectal GC/CT and MA use, independent of HIV status. Higher levels of rectal TNF-α, IL-1ß, and IL-17a were associated with rectal GC/CT. CONCLUSIONS Systemic and rectal inflammation was positively associated with rectal GC/CT and MA use. Condomless sex in the setting of GC/CT- and MA-induced immune activation may provide a basis for synergistic biobehavioral mechanisms that promote HIV/STI transmission among MSM who use MA.
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Affiliation(s)
- Cheríe S Blair
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Jennifer A Fulcher
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Grace D Cho
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Pamina M Gorbach
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA
- Department of Epidemiology, Fielding School of Public Health at UCLA, Los Angeles, CA
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; and
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Jesse L Clark
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA
- Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; and
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Garber DA, Guenthner P, Zhao C, Mitchell J, Ellis S, Jia H, Manganare M, Gazumyan A, Seaman MS, Vishwanathan SA, Heneine W, McNicholl JM. Broadly neutralizing antibody-mediated protection against simian-HIV infection among macaques with vaginal sexually transmitted infections. AIDS 2023; 37:723-31. [PMID: 36625252 DOI: 10.1097/QAD.0000000000003472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Sexually transmitted infections (STIs) increase mucosal HIV infection risk and have the potential to reduce preexposure prophylaxis efficacy. Clinical trials of a broadly neutralizing antibody (bNAb) provided proof-of-concept that passive immunization against HIV can be efficacious in people. We sought to evaluate preclinically the protective efficacy of passive bNAb immunization against simian-human immunodeficiency virus (SHIV) infection in the context of concurrent vaginal STIs. DESIGN Using a macaque model of combined ulcerative and nonulcerative vaginal STIs caused by Treponema pallidum , Chlamydia trachomatis , and Trichomonas vaginalis , we determined the protection that passively administered bNAb 10-1074 conferred against repeated vaginal SHIV challenges and compared correlates of protection to contemporaneous and historical controls without STIs. METHODS Plasma viremia was monitored via RT-qPCR assay. Concentrations of 10-1074 were determined longitudinally in plasma samples via TZM-bl pseudovirus neutralization assay. RESULTS Among macaques with vaginal STIs, a single subcutaneous injection of 10-1074 durably protected against vaginal SHIV acquisition, as compared with untreated controls. Interestingly, the median plasma concentration of 10-1074 at the time of SHIV breakthrough among macaques with STIs was significantly higher (10-fold) than that previously observed among 10-1074-treated macaques in the absence of STIs. CONCLUSION Passive immunization with 10-1074 conferred significant protection against repeated vaginal SHIV challenges among macaques harboring vaginal STIs. However, our findings suggest that higher bNAb concentrations may be required for prophylaxis when STIs are present. Our findings potentially impact dose selection for the clinical development of bNAbs and highlight the importance of additional preclinical efficacy testing in STI models.
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Etowa EB, Wong JPH, Omorodion F, Etowa J, Luginaah I. Addressing HIV Misconceptions among Heterosexual Black Men and Communities in Ontario. Healthcare (Basel) 2023; 11:healthcare11070997. [PMID: 37046924 PMCID: PMC10094559 DOI: 10.3390/healthcare11070997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Background. Black males accounted for 19.7% of all the new HIV diagnoses in Canada in 2020, yet Black people make up only 4.26% of the population. Persistent misconceptions about modes of HIV transmission need to be addressed to reduce the relatively high HIV prevalence among Black men. We described the HIV misconceptions held by some HBM in Ontario. We also identified the social determinants that are protective versus risk factors for HIV misconceptions among heterosexual Black men (HBM) in Ontario with a view to building evidence-based strategies for strengthening HIV prevention and stigma reduction among HBM and their communities in Ontario. Methods. We report quantitative findings of the weSpeak study carried out among HBM in four cities (Ottawa, Toronto, London, and Windsor) in Ontario. Sample size was 866 and sub-samples were: Ottawa (n = 210), Toronto (n = 343), London (n = 157), and Windsor (n = 156). Data were collected with survey questionnaire. The outcome variable, HIV misconception score ranging from 1 to 18, was measured by the number of statements on the HIV Knowledge Questionnaire with incorrect answers. We included three categories of independent variables in the analysis based on a stepwise and forward model selection approach. The variable categories include (i) sociodemographic background; (ii) personalised psychosocial attributes (levels of HIV misconceptions, negative condom attitude, age at sexual debut, and resilience); and (iii) socially ascribed psychosocial experiences (everyday discrimination and pro-community attitudes). After preliminary univariate and bivariate analyses, we used a hierarchical linear regression model (HLM) to predict levels of HIV misconceptions while controlling for the effect of the city of residence. Results. More than 50% of participants in all study sites were aged 20–49 years, married, and have undergone a college or university undergraduate education. Yet, a significant proportion (27.2%) held varying levels of misconceptions about HIV. In those with misconceptions, the two most common misconceptions were: (i) people are likely to get HIV by deep kissing, putting their tongue in their partner’s mouth, if their partner has HIV (40.1%); and (ii) taking a test for HIV one week after having sex will tell a person if she or he has HIV (31.6%). Discrimination (β = 0.23, p < 0.05, 95% CI = 0.01, 0.46), negative condom attitudes (β = 0.07, p < 0.05, 95% CI = 0.01, 0.12), and sexual debut at an older age (β = 0.06, p < 0.05, 95% CI = 0.01, 1) were associated with more HIV misconceptions. Being born in Canada (β = −0.96, p < 0.05, 95% CI = −1.8, −0.12), higher education (β = −0.37, p < 0.05, 95% CI = −0.52, −0.21), and being more resilient (β = −0.04, p < 0.05, 95% CI = −0.08, −0.01) were associated with fewer HIV misconceptions. Conclusion and recommendations. HIV misconceptions are still common, especially among HBM. These misconceptions are associated with structural and behavioural factors. We recommend structural and policy-driven interventions that promote more accessible and equity-driven healthcare, education, and social integration of HBM in Ontario. We also recommend building capacity for collective resilience and critical health and racial literacy as well as creating culturally safe spaces for intergenerational dialogues among HBM in their communities.
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Affiliation(s)
- Egbe B. Etowa
- Daphne Cockwell Health Sciences Complex, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
- Correspondence:
| | - Josephine Pui-Hing Wong
- Daphne Cockwell Health Sciences Complex, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Francisca Omorodion
- Department of Sociology, Anthropology and Criminology, University of Windsor, Windsor, ON N9B 3P4, Canada
| | - Josephine Etowa
- School of Nursing, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Isaac Luginaah
- Department of Geography, University of Western Ontario, London, ON N6A 3K7, Canada
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Schuettfort G, Groh A, Kann G, Haberl A, Herrmann E, Wetzstein N, Vehreschild MJGT, Stephan C. Sexually transmitted diseases in people living with HIV after implementation of cost coverage of HIV pre-exposure prophylaxis by statutory health insurance in Germany. HIV Med 2023; 24:163-169. [PMID: 35859321 DOI: 10.1111/hiv.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/08/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES After pre-exposure prophylaxis (PrEP) was introduced, rates of sexually transmitted infections (STIs) increased among PrEP users. However, data on STI trends in people living with HIV since then are limited. Since September 2019, PrEP has been covered by statutory German health insurance (SHI) in vulnerable groups. This study aimed to determine whether this coverage of PrEP costs affected STI rates in people living with HIV (specifically, men who have sex with men). METHODS All patients of the HIVCENTER Frankfurt diagnosed with at least one STI within the observation period were retrospectively enrolled in the study. STIs included infection with Treponema pallidum, Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. The observation period covered 1 year before and 1 year after the coverage of PrEP costs by German SHI. Data were collected from outpatient clinic records. RESULTS In total, 143 patients were enrolled in the study. The observation period was September 2018 to August 2019 for group 1 (n = 73) and September 2019 to August 2020 for group 2 (n = 70). The most frequent STIs were syphilis and infections due to chlamydia, gonococci, and trichomonads, in descending order. Infections with T. pallidum occurred more often in group 2 than in group 1 (60.0% vs. 50.7%; p = 0.253) as did chlamydia (37.1% vs. 28.8%; p = 0.286). CONCLUSIONS A tendency for an increased ratio of STIs in people living with HIV was observed after the introduction of PrEP coverage by German SHI. STIs should be discussed intensively with people living with HIV, since the communities of PrEP users and people living with HIV overlap, and changes in risk behaviour might influence both groups.
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Affiliation(s)
- Gundolf Schuettfort
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Ana Groh
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Gerrit Kann
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Annette Haberl
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Nils Wetzstein
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | - Christoph Stephan
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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Cantisani C, Rega F, Ambrosio L, Grieco T, Kiss N, Meznerics FA, Bánvölgyi A, Vespasiani G, Arienzo F, Rossi G, Soda G, Pellacani G. Syphilis, the Great Imitator-Clinical and Dermoscopic Features of a Rare Presentation of Secondary Syphilis. Int J Environ Res Public Health 2023; 20:1339. [PMID: 36674095 PMCID: PMC9859468 DOI: 10.3390/ijerph20021339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Syphilis is characterized by a wide range of variable clinical symptoms; therefore, it is often referred to as "The Great Imitator". Here, we report the case of a 69-year-old hepatitis-C-positive MSM patient, who was admitted to our clinic due to a solitary firm painless erythematous maculopapular lesion with a central crater-like crust on the upper right thigh that occurred two months prior. The dermoscopy showed an erythematous, copper-colored, oval lesion with diffuse monomorphic dotted and glomerular vessels, central crust, and circular scaling (Biett's sign). The histological findings ruled out neoplasia and described a plasma cell infiltrate and endothelial swelling. Finally, the combination of the dermoscopic image, histological findings and the additionally acquired knowledge about the sexual history of the patient at the second visit led to the diagnosis, which was then confirmed with serological tests. Dermoscopy may become a supportive tool to facilitate the recognition of secondary syphilis; however, the reporting of these atypical cases is crucial to highlight the many faces of the disease so that clinicians consider syphilis as part of the differential diagnosis of non-specific lesions.
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Affiliation(s)
- Carmen Cantisani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Federica Rega
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Luca Ambrosio
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Teresa Grieco
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Norbert Kiss
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - Giordano Vespasiani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Francesca Arienzo
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza Medical School” University of Rome, 00161 Rome, Italy
| | - Giovanni Rossi
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Giuseppe Soda
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza Medical School” University of Rome, 00161 Rome, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
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30
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Hojilla JC, Sarovar V, Lam JO, Park IU, Vincent W, Hare CB, Silverberg MJ, Satre DD. Sexually Transmitted Infection Screening in Key Populations of Persons Living with HIV. AIDS Behav 2023; 27:96-105. [PMID: 35916949 PMCID: PMC9851927 DOI: 10.1007/s10461-022-03747-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 01/24/2023]
Abstract
Annual screening for bacterial sexually transmitted infections (STI), including gonorrhea/chlamydia (GC/CT) and syphilis, is recommended for persons with HIV (PWH). We used the prevention index to quantify the extent to which STI screening was completed at guideline-recommended frequency in African American and Latinx persons, women, persons with alcohol (AUD) and substance (SUD) use disorders. Data from PWH at Kaiser Permanente Northern California were collected from electronic health records. We defined receipt of GC/CT and syphilis screening consistent with recommendations as a prevention index score ≥ 75%. Among 9655 PWH (17.7% Latinx; 16.2% African American; 9.6% female; 12.4% AUD; 22.1% SUD), prevention index scores for GC/CT and syphilis increased from 2015 to 2019. African American PWH had lower odds of receiving an annual syphilis screen (aOR 0.87 [95% CI 0.79-0.97]). Female sex was associated with lower odds of GC/CT (aOR 0.30 [95% CI 0.27-0.34]) and syphilis (aOR 0.27 [95% CI 0.24-0.310) screening. AUD and SUD were not associated with differences in annual GC/CT or syphilis screening. Key PWH subgroups experience ongoing challenges to annual STI screening despite comparable healthcare access.
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Affiliation(s)
- J Carlo Hojilla
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States.
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.
| | - Varada Sarovar
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Jennifer O Lam
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Ina U Park
- Department of Family and Community Medicine, University of California, San Francisco, CA, United States
| | - Wilson Vincent
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - C Bradley Hare
- Kaiser Permanente San Francisco Medical Center, San Francisco, CA, United States
| | - Michael J Silverberg
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
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31
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Miller AP, Shoptaw S, Mvududu R, Mashele N, Coates TJ, Bekker LG, Essack Z, Groenewald C, Petersen Z, Gorbach PM, Myer L, Joseph Davey DL. Sexual Risk among Pregnant Women at Risk of HIV Infection in Cape Town, South Africa: What Does Alcohol Have to Do with It? AIDS Behav 2023; 27:37-50. [PMID: 35737280 PMCID: PMC9780404 DOI: 10.1007/s10461-022-03742-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 01/24/2023]
Abstract
This study examines baseline associations between alcohol use and HIV sexual risk among a cohort of HIV-uninfected pregnant women (n = 1201) residing in a high HIV burdened community in Cape Town, South Africa. Alcohol use was measured using a modified version of the Alcohol Use Disorder Identification Test (AUDIT). HIV sexual risk was measured through a composite variable of four risk factors: diagnosis with a STI, self-report of > 1 recent sex partners, partner HIV serostatus (unknown or HIV+) and condomless sex at last sex. Any past year alcohol use prior to pregnancy was reported by half of participants (50%); 6.0% reported alcohol use during pregnancy. Alcohol use prior to pregnancy was associated with increased odds of being at high risk of HIV (aOR = 1.33, 95% CI 1.05-1.68, for 2 risks and aOR = 1.47, 95% CI 0.95-2.27 for 3 risks). In addition to reducing alcohol use, several other strategies to address HIV sexual risk were identified. Evidence-based interventions to address alcohol use and other HIV sexual risk behaviors during pregnancy in South Africa are desperately needed. Qualitative work exploring individual and community level drivers of alcohol use among pregnant and breastfeeding women in this setting could support development of a culturally tailored intervention to address these issues in this population.
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Affiliation(s)
- Amanda P Miller
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
- Department of Epidemiology, Fielding School of Public Health, 650 Charles E. Young Drive South, Room #41-295CHS, Los Angeles, CA, 90095-1772, USA.
| | - Steven Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Rufaro Mvududu
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Nyiko Mashele
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Thomas J Coates
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, Faculty of Health Science, Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Zaynab Essack
- Centre for Community-Based Research, Human Sciences Research Council, Pretoria, South Africa
| | - Candice Groenewald
- Centre for Community-Based Research, Human Sciences Research Council, Pretoria, South Africa
- Psychology Department, Rhodes University, Makhanda, South Africa
| | - Zaino Petersen
- Impact and Research Development, Human Sciences Research Council, Pretoria, South Africa
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Dvora L Joseph Davey
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- The Desmond Tutu HIV Centre, Faculty of Health Science, Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
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Majam M, Segal B, Fieggen J, Smith E, Hermans L, Singh L, Phatsoane M, Arora L, Lalla-Edward S. Utility of a machine-guided tool for assessing risk behaviour associated with contracting HIV in three sites in South Africa. Inform Med Unlocked 2023; 37:101192. [PMID: 36911795 PMCID: PMC9993399 DOI: 10.1016/j.imu.2023.101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction Digital data collection and the associated mobile health technologies have allowed for the recent exploration of artificial intelligence as a tool for combatting the HIV epidemic. Machine learning has been found to be useful both in HIV risk prediction and as a decision support tool for guiding pre-exposure prophylaxis (PrEP) treatment. This paper reports data from two sequential studies evaluating the viability of using machine learning to predict the susceptibility of adults to HIV infection using responses from a digital survey deployed in a high burden, low-resource setting. Methods 1036 and 593 participants were recruited across two trials. The first trial was a cross-sectional study in one location and the second trial was a cohort study across three trial sites. The data from the studies were merged, partitioned using standard techniques, and then used to train and evaluate multiple different machine learning models and select and evaluate a final model. Variable importance estimates were calculated using the PIMP and SHAP methodologies. Results Characteristics associated with HIV were consistent across both studies. Overall, HIV positive patients had a higher median age (34 [IQR: 29-39] vs 26 [IQR 22-33], p < 0.001), and were more likely to be female (155/703 [22%] vs 107/927 [12%], p < 0.001). HIV positive participants also had more commonly gone a year or more since their last HIV test (183/262 [70%] vs 540/1368 [39%], p < 0.001) and were less likely to report consistent condom usage (113/262 [43%] vs 758/1368 [55%], p < 0.001). Patients who reported TB symptoms were more likely to be HIV positive. The trained models had accuracy values (AUROCs) ranging from 78.5% to 82.8%. A boosted tree model performed best with a sensitivity of 84% (95% CI 72-92), specificity of 71% (95% CI 67-76), and a negative predictive value of 95% (95% CI 93-96) in a hold-out dataset. Age, duration since last HIV test, and number of male sexual partners were consistently three of the four most important variables across both variable importance estimates. Conclusions This study has highlighted the synergies present between mobile health and machine learning in HIV. It has been demonstrated that a viable ML model can be built using digital survey data from an low-middle income setting with potential utility in directing health resources.
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Affiliation(s)
- M. Majam
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - B. Segal
- Phithos Technologies, Johannesburg, South Africa
| | - J. Fieggen
- Phithos Technologies, Johannesburg, South Africa
| | - Eli Smith
- Phithos Technologies, Johannesburg, South Africa
| | - L. Hermans
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands
- Infectious Diseases Unit, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - L. Singh
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - M. Phatsoane
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - L. Arora
- Phithos Technologies, Johannesburg, South Africa
| | - S.T. Lalla-Edward
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Corresponding author. Ezintsha, Building C, Sunnyside Office Park, 32 Princess of Wales Terrace, Parktown, Gauteng, 2000, South Africa.
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Abstract
Despite advances in reducing HIV-related mortality, persistently high HIV incidence rates are undermining global efforts to end the epidemic by 2030. The UNAIDS Fast-track targets as well as other preventative strategies, such as pre-exposure prophylaxis, have been identified as priority areas to reduce the ongoing transmission threatening to undermine recent progress. Accurate and granular risk prediction is critical for these campaigns but is often lacking in regions where the burden is highest. Owing to their ability to capture complex interactions between data, machine learning and artificial intelligence algorithms have proven effective at predicting the risk of HIV infection in both high resource and low resource settings. However, interpretability of these algorithms presents a challenge to the understanding and adoption of these algorithms. In this perspectives article, we provide an introduction to machine learning and discuss some of the important considerations when choosing the variables used in model development and when evaluating the performance of different machine learning algorithms, as well as the role emerging tools such as Shapely Additive Explanations may play in helping understand and decompose these models in the context of HIV. Finally, we discuss some of the potential public health and clinical use cases for such decomposed risk assessment models in directing testing and preventative interventions including pre-exposure prophylaxis, as well as highlight the potential integration synergies with algorithms that predict the risk of sexually transmitted infections and tuberculosis.
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Affiliation(s)
- Joshua Fieggen
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa,Phithos Technologies, Johannesburg, South Africa,Correspondence: Joshua Fieggen ;
| | - Eli Smith
- Phithos Technologies, Johannesburg, South Africa
| | | | - Bradley Segal
- Phithos Technologies, Johannesburg, South Africa,Department of Biomedical Engineering, University of the Witwatersrand, Johannesburg, South Africa
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Karim QA, Archary D, Barré-Sinoussi F, Broliden K, Cabrera C, Chiodi F, Fidler SJ, Gengiah TN, Herrera C, Kharsany ABM, Liebenberg LJP, Mahomed S, Menu E, Moog C, Scarlatti G, Seddiki N, Sivro A, Cavarelli M. Women for science and science for women: Gaps, challenges and opportunities towards optimizing pre-exposure prophylaxis for HIV-1 prevention. Front Immunol 2022; 13:1055042. [PMID: 36561760 PMCID: PMC9763292 DOI: 10.3389/fimmu.2022.1055042] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
Preventing new HIV infections remains a global challenge. Young women continue to bear a disproportionate burden of infection. Oral pre-exposure prophylaxis (PrEP), offers a novel women-initiated prevention technology and PrEP trials completed to date underscore the importance of their inclusion early in trials evaluating new HIV PrEP technologies. Data from completed topical and systemic PrEP trials highlight the role of gender specific physiological and social factors that impact PrEP uptake, adherence and efficacy. Here we review the past and current developments of HIV-1 prevention options for women with special focus on PrEP considering the diverse factors that can impact PrEP efficacy. Furthermore, we highlight the importance of inclusion of female scientists, clinicians, and community advocates in scientific efforts to further improve HIV prevention strategies.
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Affiliation(s)
- Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute (2Floor), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Derseree Archary
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute (2Floor), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa,Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | | | - Kristina Broliden
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, Department of Infectious Diseases, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden
| | - Cecilia Cabrera
- AIDS Research Institute IrsiCaixa, Institut de Recerca en Ciències de la Salut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesca Chiodi
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Sarah J. Fidler
- Department of Infectious Disease, Faculty of Medicine, Imperial College London UK and Imperial College NIHR BRC, London, United Kingdom
| | - Tanuja N. Gengiah
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute (2Floor), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Carolina Herrera
- Department of Infectious Disease, Section of Virology, Faculty of Medicine, Imperial College London, London, United Kingdom,*Correspondence: Carolina Herrera,
| | - Ayesha B. M. Kharsany
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute (2Floor), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa,Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Lenine J. P. Liebenberg
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute (2Floor), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa,Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sharana Mahomed
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute (2Floor), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Elisabeth Menu
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France,MISTIC Group, Department of Virology, Institut Pasteur, Paris, France
| | - Christiane Moog
- Laboratoire d’ImmunoRhumatologie Moléculaire, Institut national de la santé et de la recherche médicale (INSERM) UMR_S 1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Gabriella Scarlatti
- Viral Evolution and Transmission Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Nabila Seddiki
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Aida Sivro
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute (2Floor), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa,Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa,JC Wilt Infectious Disease Research Centre, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Mariangela Cavarelli
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
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Bosetti D, Mugglin C, Calmy A, Cavassini M, Stöckle M, Braun D, Notter J, Haerry D, Hampel B, Kovari H, Bernasconi E, Wandeler G, Rauch A, Aebi-Popp K, Anagnostopoulos A, Battegay M, Bernasconi E, Braun DL, Bucher HC, Calmy A, Cavassini M, Ciuffi A, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Günthard HF, Hachfeld A, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Huber M, Kahlert CR, Kaiser L, Keiser O, Klimkait T, Kouyos RD, Kovari H, Kusejko K, Martinetti G, Martinez de Tejada B, Marzolini C, Metzner KJ, Müller N, Nemeth J, Nicca D, Paioni P, Pantaleo G, Perreau M, Rauch A, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Wandeler G, Yerly S. Risk Factors and Incidence of Sexually Transmitted Infections in the Swiss HIV Cohort Study. Open Forum Infect Dis 2022; 9:ofac592. [PMID: 36504700 PMCID: PMC9728517 DOI: 10.1093/ofid/ofac592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are common among people with human immunodeficiency virus (PWH), but there are limited data about risk factors and incidence of STIs in large, representative cohort studies. Methods We assessed incidence and risk factors of STIs reported by treating physicians within the Swiss HIV Cohort Study (SHCS). Sexually transmitted infections and demographic, clinical, and behavioral characteristics were prospectively collected at 6-month follow-up visits between October 2017 and November 2019. We used multilevel Poisson regression to assess incidence rate ratios of different STIs. Results Among 10 140 study participants, a total of 1634 STIs in 1029 SHCS participants were reported over 17 766 person-years of follow up (PYFUP). The overall incidence of any reported STI was 91.9 per 1000 PYFU (95% confidence interval [CI], 85.8 -98.5). Among the 1634 STI episodes, there were 573 (35.1%) incident cases of syphilis, 497 gonorrhea (30.4%), and 418 chlamydia (25.6%). Men who have sex with men (MSM) younger than 50 years represented 21% of the study population, but accounted for 61% of reported STIs. Male sex (adjusted incidence rate ratio [aIRR], 2.03; 95% CI, 1.36-3.02), MSM (aIRR, 3.62; 95% CI, 2.88-4.55), age group 18-34 years (aIRR, 1.78; 95% CI, 1.51-2.10), history of sexual relationships with occasional partners (aIRR, 6.87; 95% CI, 5.40-8.73), and reporting injecting drug use (aIRR, 2.48; 95% CI, 1.91-3.23) were associated with a higher risk of incident STIs. Conclusions Sexually transmitted infections were frequent among PWH and varied considerably between age and risk groups. Screening programs and recommendations for STI testing need to be adapted according to risk factors and demographic characteristics.
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Affiliation(s)
| | - Catrina Mugglin
- Correspondence: Catrina Mugglin, MSc, MD, PhD, Inselspital, Bern University Hospital, Freiburgstrasse, CH-3010 Bern, Switzerland ()
| | - Alexandra Calmy
- HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland
| | - Matthias Cavassini
- University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Marcel Stöckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Dominique Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Julia Notter
- Division of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
| | | | - Benjamin Hampel
- Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland,Checkpoint Zurich, Zurich, Switzerland
| | - Helen Kovari
- Zentrum für Infektionskrankheiten, Klinik im Park, Zurich, Switzerland
| | - Enos Bernasconi
- Ente Ospedaliero Cantonale, Lugano, University of Geneva, and University of Southern Switzerland, Lugano, Switzerland
| | - Gilles Wandeler
- Department of Infectious Diseases, University Hospital of Geneva, University of Geneva, Geneva, Switzerland
| | - Andri Rauch
- Department of Infectious Diseases, University Hospital of Geneva, University of Geneva, Geneva, Switzerland
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Pressley M, Mahgoub S, Halawani M. Facilitators and Barriers to the Implementation of Interventions in Washington, DC, to Improve Sexually Transmitted Infection Screening, Testing, and Treatment Among People with or at Risk of HIV. AIDS Patient Care STDS 2022; 36:117-126. [PMID: 36178402 DOI: 10.1089/apc.2022.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Bacterial sexually transmitted infection (STI) incidences of gonorrhea, chlamydia, and syphilis are increasing in Washington, DC. Moreover, the availability of HIV pre-exposure prophylaxis for people at risk of HIV and condomless sex has increased, and bacterial STI rates have risen. This indicates the necessity of evidence-based strategies to ensure access to STI care and improve health outcomes for people with HIV in Washington, DC. Three clinics in Washington, DC, implemented three evidence-based interventions, including the use of a standardized audio computer-assisted self-interview to obtain an interval sexual history at each clinic visit, patient self-collection of chlamydia/gonorrhea nucleic acid amplification test specimens, and sexual minority welcoming clinical space indicators to normalize STI screening and testing. Three sites in Washington, DC, used a multi-level socioecological model to identify successes, challenges, and lessons learned from program implementation at the following three levels: (1) individual, (2) interpersonal, and (3) public policy. We conclude with a series of instructional strategies that may be useful for the implementation of similar interventions that may assist district-wide responses to decrease health disparities and increase STI prevention.
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Affiliation(s)
- Megan Pressley
- Infectious Diseases Division, Department of Medicine, Howard University Hospital, Center for Infectious Diseases Management & Research (CIDMAR), Howard University College of Medicine, Washington, District of Columbia, USA
| | - Siham Mahgoub
- Infectious Diseases Division, Department of Medicine, Howard University Hospital, Center for Infectious Diseases Management & Research (CIDMAR), Howard University College of Medicine, Washington, District of Columbia, USA
| | - Mirna Halawani
- School of Nursing, Rutgers University, Newark, New Jersey, USA
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Young LE, Tang JL, Nan Y. Social Media Communication and Network Correlates of HIV Infection and Transmission Risks Among Black Sexual Minority Men: Cross-sectional Digital Epidemiology Study. JMIR Form Res 2022; 6:e37982. [PMID: 36264617 PMCID: PMC9634521 DOI: 10.2196/37982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/27/2022] [Accepted: 09/06/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In the United States, HIV disproportionately affects Black cisgender sexual minority men (BSMM). Although epidemiological and behavioral surveillance are integral to identifying BSMM at risk of HIV infection and transmission, overreliance on self-reported data, inability to observe social contexts, and neglect of populations with limited engagement in health care systems limits their effectiveness. Digital epidemiological approaches drawing on social media data offer an opportunity to overcome these limitations by passively observing in organic settings activities, beliefs, behaviors, and moods that indicate health risks but are otherwise challenging to capture. OBJECTIVE The primary aim of this study was to determine whether features of Facebook communication and networks were associated with biological, behavioral, and psychological indicators of HIV infection and transmission risk. METHODS Facebook and survey data were collected from BSMM aged 18 to 35 years living in Chicago (N=310). Participants' Facebook posts were characterized using 4 culturally tailored topic dictionaries related to aspects of HIV protection and risk among BSMM (sexual health; substance use; sex behavior; and ballroom culture, a salient subculture in lesbian, gay, bisexual, transgender, and queer communities of color). Social network methods were used to capture structural features of BSMM's Facebook friendships (centrality, brokerage, and local clustering) and Facebook group affiliations. Multivariable regressions revealed relationships between these Facebook features and 5 ground truth indicators of HIV infection and transmission risk (sexually transmitted infection incidence, condomless sex, sex drug use, biomedical prevention, and depression). RESULTS Although analysis of participants' Facebook posts revealed that HIV-related topics occupied a small portion of the total messages posted by each participant, significant associations were found between the following HIV risk indicators and Facebook features: Condomless sex, including communication about sexual health (odds ratio [OR] 1.58, 95% CI 1.09-2.29), ballroom culture (OR 0.76, 95% CI 0.63-0.93), and friendship centrality (OR 0.69, 95% CI 0.52-0.92); Sex drug use, including communication about substance use (OR 1.81, 95% CI 1.17-2.79) and friendship centrality (OR 0.73, 95% CI 0.55-0.96) and brokerage (OR 0.71, 95% CI 0.51-0.99); Biomedical prevention, including communication about ballroom culture (OR 0.06, 95% CI 0.01-0.71); and Depression, including communication about sexual health (β=-0.72, 95% CI -1.42 to -0.02), ballroom culture (β=.80, 95% CI 0.27-1.34), friendship centrality (β=-0.90, 95% CI -1.60 to -0.21), and Facebook group affiliations (β=.84, 95% CI 0.25-1.43). Facebook features provided no significant explanatory value for sexually transmitted infection incidence. CONCLUSIONS Finding innovative strategies to detect BSMM at risk of contracting or transmitting HIV is critical to eliminating HIV disparities in this community. The findings suggest that social media data enable passive observance of social and communicative contexts that would otherwise go undetected using traditional HIV surveillance methods. As such, social media data are promising complements to more traditional data sources.
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Affiliation(s)
- Lindsay E Young
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
| | - Jack Lipei Tang
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
| | - Yuanfeixue Nan
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
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Sewell J, Fakoya I, Lampe FC, Howarth A, Phillips A, Burns F, Rodger AJ, Cambiano V. Effectiveness of interventions aimed at reducing HIV acquisition and transmission among gay and bisexual men who have sex with men (GBMSM) in high income settings: A systematic review. PLoS One 2022; 17:e0276209. [PMID: 36260550 DOI: 10.1371/journal.pone.0276209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION HIV transmission continues among gay and bisexual men who have sex with men (GBMSM), with those who are younger, or recent migrants, or of minority ethnicity or who are gender diverse remaining at increased risk. We aimed to identify and describe recent studies evaluating the effectiveness of HIV prevention interventions for GBMSM in high income countries. METHODS We searched ten electronic databases for randomized controlled trials (RCTs), conducted in high income settings, and published since 2013 to update a previous systematic review (Stromdahl et al, 2015). We predefined four outcome measures of interest: 1) HIV incidence 2) STI incidence 3) condomless anal intercourse (CLAI) (or measure of CLAI) and 4) number of sexual partners. We used the National Institute for Health and Care Excellence (UK) Quality Appraisal of Intervention Studies tool to assess the quality of papers included in the review. As the trials contained a range of effect measures (e.g. odds ratio, risk difference) comparing the arms in the RCTs, we converted them into standardized effect sizes (SES) with 95% confidence intervals (CI). RESULTS We identified 39 original papers reporting 37 studies. Five intervention types were identified: one-to-one counselling (15 papers), group interventions (7 papers), online interventions (9 papers), Contingency Management for substance use (2 papers) and Pre-exposure Prophylaxis (PrEP) (6 papers). The quality of the studies was mixed with over a third of studies rated as high quality and 11% rated as poor quality. There was some evidence that one-to-one counselling, group interventions (4-10 participants per group) and online (individual) interventions could be effective for reducing HIV transmission risk behaviours such as condomless anal intercourse. PrEP was the only intervention that was consistently effective at reducing HIV incidence. CONCLUSIONS Our systematic review of the recent evidence that we were able to analyse indicates that PrEP is the most effective intervention for reducing HIV acquisition among GBMSM. Targeted and culturally tailored behavioural interventions for sub-populations of GBMSM vulnerable to HIV infection and other STIs should also be considered, particularly for GBMSM who cannot access or decline to use PrEP.
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Peters RP, Garrett N, Chandiwana N, Kularatne R, Brink AJ, Cohen K, Gill K, Chidarikire T, Wattrus C, Nel JS, Moosa MY, Bekker LG. Southern African HIV Clinicians Society 2022 guideline for the management of sexually transmitted infections: Moving towards best practice. South Afr J HIV Med 2022; 23:1450. [PMID: 36299557 PMCID: PMC9575338 DOI: 10.4102/sajhivmed.v23i1.1450] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Remco P.H. Peters
- Research Unit, Foundation for Professional Development, East London, South Africa,Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa,Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa,Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Nomathemba Chandiwana
- Ezintsha, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Ranmini Kularatne
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adrian J. Brink
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Karen Cohen
- Department of Medicine, Division of Clinical Pharmacology, University of Cape Town, Cape Town, South Africa
| | - Katherine Gill
- Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | | | - Camilla Wattrus
- Southern African HIV Clinicians Society (SAHCS), Johannesburg, South Africa
| | - Jeremy S. Nel
- Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - Mahomed Y.S. Moosa
- Department of Infectious Disease, Division of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
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Laurence J. The Recent Rise in Sexually Transmitted Infections in the United States Was a Harbinger of the New Monkeypox Pandemic. AIDS Patient Care STDS 2022; 36:333-335. [PMID: 35947858 DOI: 10.1089/apc.2022.29009.com] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Jeffrey Laurence
- Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
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Asare K, Osman F, Ngcapu S, Vandormael A, Naicker N, Khanyile M, Mindel A, Abdool Karim SS, Tomita A, Garrett N. Burden of sexually transmitted infections from acute HIV infection among women in South Africa: Evidence from a prospective cohort study. Ann Epidemiol 2022; 74:132-139. [PMID: 35977656 DOI: 10.1016/j.annepidem.2022.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/26/2022] [Accepted: 08/09/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE HIV and other sexually transmitted infections (STIs) often co-occur. However, less evidence exists on the long-term STI dynamics among persons living with HIV in sub-Saharan Africa to inform interventions. We investigated the incidence, prevalence and factors associated with STIs, starting from acute HIV infection in a cohort of South African women. METHODS The CAPRISA002 study enrolled women with acute HIV infection and performed STI testing and treatment 1-2 times annually from 2004-2020. We estimated STI incidence, re-infection, and prevalence trends before and after antiretroviral treatment (ART). We fitted Cox regression models to identify factors associated with STIs. RESULTS We followed up 235 women (median age = 25 years, IQR 22-29) for 7.5 years (IQR 5.7-10.8). New STI and re-infection cases per 100 person-years (PYs) were 5.1 and 9.5 for Neisseria gonorrhoeae (NG), 7.4 and 14.7 for Chlamydia trachomatis (CT), 8.0 and 26.6 for Trichomonas vaginalis (TV), 7.7 and 16.7 for Mycoplasma genitalium (MG) and 25.2 and 37.3 for any STI. STI incidence, was associated with HIV log10 viral load (AHR = 1.24, 95% CI 1.06-1.44), active syphilis (AHR = 16.55, 95% CI 7.49-36.55), a positive HSV-2 PCR (AHR = 1.54, 95% CI 1.01-2.35), bacterial vaginosis (AHR = 1.48, 95% CI 1.01-2.18), recent regular sexual partners at enrolment (one vs none: AHR = 2.62, 95% CI 1.41-4.87; two plus vs none: AHR = 3.68, 95% CI 1.79-7.59) and age (5-year fold: AHR = 0.80, 95% CI 0.70-0.92). CONCLUSION The persistent STI/HIV co-infection burden among South African women highlights that early HIV diagnosis and ART initiation needs to be combined with better STI care for women and their partners to prevent HIV and STI transmission.
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Affiliation(s)
- Kwabena Asare
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.
| | - Farzana Osman
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Sinaye Ngcapu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Alain Vandormael
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Nivashnee Naicker
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Mlungisi Khanyile
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Adrian Mindel
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Salim S Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa; Department of Epidemiology, Columbia University, New York, New York, USA
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Nigel Garrett
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
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Sarenje KL, Ngalamika O, Maimbolwa MC, Siame A, Munsaka SM, Kwenda G. Antimicrobial resistance of Neisseria gonorrhoeae isolated from patients attending sexually transmitted infection clinics in Urban Hospitals, Lusaka, Zambia. BMC Infect Dis 2022; 22:688. [PMID: 35962370 DOI: 10.1186/s12879-022-07674-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/05/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Neisseria gonorrhoeae, the causative agent for sexually transmitted infection (STI) gonorrhoea, has emerged with a significant public health impact on acquiring resistance to antimicrobials available for treatment. The resistance of N. gonorrhoeae limit treatment options and contributed to high morbidity associated with gonorrhoea. Data on antimicrobial resistance (AMR) profiles in N. gonorrhoeae is scares in Zambia. This study aimed to determine the antibiotic susceptibilities in N. gonorrhoeae isolates from Lusaka, Zambia. METHODS A prospective cross-sectional study was conducted on 630 STI patients who presented with urethral or vaginal discharge from 2019 to 2020. Urethral and endocervical secretions were cultured on Modified Thayer Martin agar and incubated at 36 °C ± 1 °C in 5% CO2 for 24 h. Identification of N. gonorrhoeae isolates was achieved by Gram stain, oxidase, nitrocefin disk, BactiCard Neisseria, and Viteck® Compact. The AMR profiles were determined using E-test. Statistical significant was determined by Pearson's Chi-square test, Mann-Whitney U test, or logistic regression with p-values of < 0.05 indicating significance. RESULTS A total of 630 patients were recruited of which 46% (290/630) with the median of 29 years and interquartile range (IQR) of 19-39 years were male. The median of the females was 26 years and IQR of 15-37 years. Neisseria gonorrhoeae was isolated from 19.4% (122/630) patients of which 72.9% (89/122) were male, with highest prevalence of isolation in the age category of 25-34 years. The prevalence of resistance was high to penicillin (85.2%), tetracycline (68.9%) and ciprofloxacin (59.8%) with MIC90 of 32 µg/mL, 8 µg/mL, and 8 µg/mL respectively. The isolates had reduced susceptibility to cefixime (1.6%), spectinomycin (4.9%) and (4.9%) for azithromycin. All isolates were susceptible to ceftriaxone. Risk factors associated with AMR were douching in females (AOR 6.69, 95% CI; 1.11-40.31, p = 0.039), female gender (AOR 7.64, 95% CI; 1.11-52.33, p = 0.048), HIV-positivity (AOR 26.59, 95% CI; 3.67-192.7, p = 0.005), no condom use or unprotected sex (AOR 5.48, 95% CI; 1.17-22.75 p = 0.026), sex trading (AOR 4.19, 95% CI; 1.55-11.33, p = 0.010), and over-counter treatment of ciprofloxacin (AOR 3.44, 95% CI; 1.17-22.75, p = 0.023). CONCLUSION The N. gonorrhoeae resistance to penicillin, tetracycline and ciprofloxacin was high necessitating revision of the treatment guidelines. However, no resistance to ceftriaxone was detected. Therefore, monitoring of antibiotic resistance remains critical in Zambia.
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Chen F, Tang H, Han J, Li D, Li P, Wang N, Han M, Wang L, Wang L. Association of HCV Prior Infection and Unprotected Sex on Subsequent HIV Acquisition Risk in the Era of Treatment as Prevention. Front Med (Lausanne) 2022; 9:902271. [PMID: 35685415 PMCID: PMC9171012 DOI: 10.3389/fmed.2022.902271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Backgrounds Little was known about the impact of HCV prior infection on HIV transmission and acquisition. We aimed to explore whether HCV prior infection and its interactions with unprotected sex affected HIV acquisition. Methods This study was conducted among HIV heterosexual serodiscordant couples whose index cases were receiving treatment during 2008–2014 in Zhumadian. At baseline, we collected information on demographics and medical history of ART use, CD4 count, and HIV viral load for index partners, and also HIV and HCV status for non-index partners. For each year's visit, we followed up on sexual behaviors among couples in the recent year and HIV seroconversion of non-index partners. Analyses of the Cox model and synergistic interaction were performed. Results We identified 81 HIV seroconversions over 18,370.39 person-years, with the overall HIV seroconversion rate of 0.44 per 100 person-years. Couples, whose index cases were aged 50 years and above, had a baseline viral load >400 copies per ml and no AIDS-defining illness, and newly-initiated ART in the study period had a higher risk of HIV seroconversion. Unprotected sex and HCV prior infection showed a synergistic association with HIV acquisition risk (RERI = 3.65, SI = 0.48, AP = 2.24). Conclusion Unprotected sex and HCV infection were independent risk factors associated with HIV acquisition. The coexistence of them might have a synergistic effect on the risk which needs further research.
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Affiliation(s)
- Fangfang Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Han
- Department of AIDS/STD Control and Prevention, Zhumadian Center for Disease Control and Prevention, Zhumadian, Henan, China
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peilong Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ning Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengjie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lan Wang
- Editorial Department of Chinese Journal of Epidemiology, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Kaul R, Liu CM, Park DE, Galiwango RM, Tobian AAR, Prodger JL. The Penis, the Vagina and HIV Risk: Key Differences (Aside from the Obvious). Viruses 2022; 14:v14061164. [PMID: 35746636 PMCID: PMC9227947 DOI: 10.3390/v14061164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/20/2022] [Accepted: 05/22/2022] [Indexed: 12/14/2022] Open
Abstract
Globally, most Human Immunodeficiency Virus type 1 (HIV) transmission occurs through vaginal–penile sex (heterosexual transmission). The local immune environment at the site of HIV exposure is an important determinant of whether exposure during sex will lead to productive infection, and the vaginal and penile immune milieus are each critically shaped by the local microbiome. However, there are key differences in the microbial drivers of inflammation and immune quiescence at these tissue sites. In both, a high abundance of anaerobic taxa (e.g., Prevotella) is associated with an increased local density of HIV target cells and an increased risk of acquiring HIV through sex. However, the taxa that have been associated to date with increased risk in the vagina and penis are not identical. Just as importantly, the microbiota associated with comparatively less inflammation and HIV risk—i.e., the optimal microbiota—are very different at the two sites. In the vagina, Lactobacillus spp. are immunoregulatory and may protect against HIV acquisition, whereas on the penis, “skin type” flora such as Corynebacterium are associated with reduced inflammation. Compared to its vaginal counterpart, much less is known about the dynamics of the penile microbiome, the ability of clinical interventions to alter the penile microbiome, or the impact of natural/induced microbiome alterations on penile immunology and HIV risk.
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Affiliation(s)
- Rupert Kaul
- Departments of Medicine and Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Department of Medicine, University Health Network, Toronto, ON M5S 1A8, Canada
| | - Cindy M. Liu
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; (C.M.L.); (D.E.P.)
| | - Daniel E. Park
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; (C.M.L.); (D.E.P.)
| | | | - Aaron A. R. Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Jessica L. Prodger
- Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Correspondence:
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Geretti AM, Mardh O, de Vries HJC, Winter A, McSorley J, Seguy N, Vuylsteke B, Gokengin D. Sexual transmission of infections across Europe: appraising the present, scoping the future. Sex Transm Infect 2022; 98:sextrans-2022-055455. [PMID: 35537800 DOI: 10.1136/sextrans-2022-055455] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/24/2022] [Indexed: 01/13/2023] Open
Abstract
Objectives: Our journal partnered with the Europe section of the International Union against STI (IUSTI) at a workshop held at the 18th European AIDS Conference in London on 30 October 2021. The workshop reviewed epidemiological trends and discussed STI care provision within HIV services across Europe. Methods and Results: We started by highlighting trends in bacterial STIs reported to the European Centre for Disease Prevention and Control from countries in the European Union/European Economic Area. This showed that notifications of bacterial STIs reached an all-time high in 2019, but are expected to be impacted by the COVID-19 pandemic in 2020-2021. We then reviewed the evolving relationship between STIs and HIV and pointed out how antiretroviral treatment and pre-exposure prophylaxis remain highly effective against HIV transmission despite the rising incidence of STIs. Within emerging concepts in STIs, we appraised the benefits and risks of asymptomatic screening for chlamydia, and also considered the potential perils of routinely testing for agents that lack a defined role in disease. Finally, we discussed standards of STI care for people living with HIV, informed by a brief survey of IUSTI Europe country representatives and members of the Euroguidelines in Central and Eastern Europe network. Conclusions: The survey indicated substantial variability and identified key improvement targets: fighting barriers to effective service provision and access, increasing diagnostic capability and taking leadership in driving up the quality of care. We must not forget the STI-related needs of the many people who will be living with HIV for decades into the future.
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Affiliation(s)
- Anna Maria Geretti
- Dept. of Infectious Diseases, Fondazione PTV and University of Rome Tor Vergata, Rome, Italy
- School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Otilia Mardh
- HIV/STI & Hepatitis, European Centre for Disease Prevention & Control (ECDC), Solna, Sweden
| | - Henry J C de Vries
- Dept. of Dermatology, University of Amsterdam and Public Health Service, Amsterdam, The Netherlands
| | - Andrew Winter
- Sandyford Sexual Health, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - John McSorley
- The Patrick Clements Centre, London North West Healthcare NHS Trust, London, UK
| | - Nicole Seguy
- Regional Office for Europe, World Health Organization (WHO), Copenhagen, Denmark
| | - Bea Vuylsteke
- Dept. of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Deniz Gokengin
- Dept. of Infectious Diseases, Ege University, İzmir, Turkey
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Hamill MM, Onzia A, Wang TH, Kiragga AN, Hsieh YH, Parkes-Ratanshi R, Gough E, Kyambadde P, Melendez JH, Manabe YC. High burden of untreated syphilis, drug resistant Neisseria gonorrhoeae, and other sexually transmitted infections in men with urethral discharge syndrome in Kampala, Uganda. BMC Infect Dis 2022; 22:440. [PMID: 35525934 PMCID: PMC9077641 DOI: 10.1186/s12879-022-07431-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Prompt diagnosis and treatment of sexually transmitted infections (STIs) are essential to combat the STI epidemic in resource-limited settings. We characterized the burden of 5 curable STIs chlamydia, gonorrhea, trichomoniasis, Mycoplasma genitalium, syphilis, and HIV infection in Ugandan men with urethritis. METHODS Participants were recruited from a gonococcal surveillance program in Kampala, Uganda. Questionnaires, penile swabs were collected and tested by nucleic acid amplification. Gonococcal isolates were tested for antimicrobial sensitivity. Sequential point-of-care tests on blood samples were used to screen for syphilis and HIV. Bivariable and multivariable multinomial logistic regression models were used to estimate odds ratios for preselected factors likely to be associated with STIs. Adherence to STI treatment guidelines were analyzed. RESULTS From October 2019 to November 2020, positivity (95% CI) for gonorrhea, chlamydia, trichomoniasis, and Mycoplasma genitalium, were 66.4% (60.1%, 72.2%), 21.7% (16.8%, 27.4%), 2.0% (0.7%, 4.9%), and 12.4% (8.7%, 17.3%) respectively. All Neisseria gonorrhoeae isolates were resistant to ciprofloxacin, penicillin, and tetracycline, but susceptible to extended spectrum cephalosporins and azithromycin. HIV and syphilis prevalence was 20.0% (50/250) and 10.0% (25/250), and the proportion unaware of their infection was 4.0% and 80.0% respectively. Most participants were treated per national guidelines. Multivariable analysis demonstrated significant associations between curable STI coinfections and younger age, transactional sex, but not HIV status, nor condom or alcohol use. CONCLUSIONS STI coinfections including HIV their associated risk factors, and gonococcal AMR were common in this population. The majority with syphilis were unaware of their infection and were untreated. Transactional sex was associated with STI coinfections, and > 80% of participants received appropriate treatment.
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Affiliation(s)
- Matthew M Hamill
- Division of Infectious Disease, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Suite 381, Baltimore, MD, 21224, USA.
| | - Annet Onzia
- Infectious Disease Institute, Kampala, Uganda
| | | | | | - Yu-Hsiang Hsieh
- Division of Infectious Disease, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Suite 381, Baltimore, MD, 21224, USA
| | | | - Ethan Gough
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Peter Kyambadde
- Ministry of Health, National Sexually Transmitted Infections Control Program, Kampala, Uganda
| | - Johan H Melendez
- Division of Infectious Disease, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Suite 381, Baltimore, MD, 21224, USA
| | - Yukari C Manabe
- Division of Infectious Disease, Johns Hopkins School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Suite 381, Baltimore, MD, 21224, USA.,Infectious Disease Institute, Kampala, Uganda
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Fatima F, Kumar S, Das A. Vaccines against sexually transmitted infections: an update. Clin Exp Dermatol 2022; 47:1454-1463. [DOI: 10.1111/ced.15223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 12/09/2022]
Affiliation(s)
- Farhat Fatima
- Department of Dermatology, Venereology, and Leprosy; Medical College & Hospital Kolkata India
| | - Satarupa Kumar
- Department of Dermatology, Venereology, and Leprosy; Medical College & Hospital Kolkata India
| | - Anupam Das
- Department of Dermatology, Venereology, and Leprosy; KPC Medical College & Hospital Kolkata India
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Kutner BA, Zucker J, López-Rios J, Lentz C, Dolezal C, Balán IC. Infrequent STI Testing in New York City Among High Risk Sexual and Gender Minority Individuals Interested In Self- and Partner-Testing. AIDS Behav 2022; 26:1153-1162. [PMID: 34554292 DOI: 10.1007/s10461-021-03468-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 12/15/2022]
Abstract
Testing for sexually transmitted infections (STIs) remains low among sexual and gender minority populations. We assessed STI testing history using a retrospective survey among 129 HIV-negative cisgender men who have sex with men (cMSM) and transgender women who have sex with men (tWSM) who were at high risk for STI acquisition. All participants were enrolled in a parent study on self- and partner-testing for HIV and syphilis, and reported condomless anal intercourse with multiple partners during the prior 3 months. We additionally used bivariate tests to evaluate participants' STI testing by their history of using pre-exposure prophylaxis (PrEP). One-in-seven respondents (n = 18) reported having never tested for an STI, one-quarter (n = 33) had not tested in the past year, and two-thirds (n = 83) had never used PrEP. PrEP-naïve respondents were less likely to report recent STI testing (47% vs. 85%). "Routine doctor's visit" was the most prevalent reason for testing, but was less common among PrEP-naïve respondents (83% vs. 100%). Testing was remarkably low given the sample's high risk of HIV and STI infection. Findings suggest that STI testing is more frequent among those who have ever used PrEP, but the risk of selection bias warrants evaluation in a larger probability sample.
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Affiliation(s)
- Bryan A Kutner
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Jason Zucker
- Columbia University Irving Medical Center, New York, NY, USA
| | - Javier López-Rios
- Department of Community Health & Prevention, Dornsife School of Public Health Drexel University, 3215 Market street, Nesbitt Hall, 4th Fl., Philadelphia, PA, USA
| | - Cody Lentz
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Curtis Dolezal
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Iván C Balán
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA.
- Center for Translational Behavioral Science, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 2010 Levy Ave Building B, Suite B0266, Tallahassee, FL, 32310, USA.
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Jones J, Zlotorzynska M, Villarino X, Sanchez T. Where is Rural? Examining the Effect of Rural Classification Method on Disparities in HIV and STI Testing Uptake Among Men Who Have Sex with Men in the United States. AIDS Behav 2022. [PMID: 35244818 DOI: 10.1007/s10461-022-03635-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/16/2022]
Abstract
Men who have sex with men (MSM) account for the majority of new HIV diagnoses in the United States, including in rural areas, and MSM in rural areas face additional barriers to accessing culturally competent and appropriate HIV/STI preventive care. Multiple methods have been used to classify areas in the United States as rural, but none of these methods is specifically designed to classify areas with respect to access to culturally competent care for MSM. Using data from a large, cross-sectional study of MSM we assessed the effect of using three different methods for classifying rurality on measurements of sexual behavior and HIV/STI testing uptake. We found that the prevalence of condomless anal sex and PrEP eligibility was similar across levels of rurality regardless of the method of classification used. Across all measures of rurality, rural MSM were less likely to have tested for HIV and STIs than non-rural MSM. The disparity in HIV/STI testing persisted even in the most inclusive measure of rurality used, indicating that HIV/STI prevention studies should consider using an inclusive approach to identifying and defining rurality.
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Lujan AL, Croci DO, Rabinovich GA, Damiani MT. Galectins as potential therapeutic targets in STIs in the female genital tract. Nat Rev Urol 2022; 19:240-252. [PMID: 35105978 DOI: 10.1038/s41585-021-00562-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2021] [Indexed: 12/12/2022]
Abstract
Every day, more than one million people worldwide acquire a sexually transmitted infection (STI). This public health problem has a direct effect on women's reproductive and sexual health as STIs can cause irreversible damage to fertility and can have negative consequences associated with discrimination and social exclusion. Infection with one sexually transmitted pathogen predisposes to co-infection with others, suggesting the existence of shared pathways that serve as molecular links between these diseases. Galectins, a family of β-galactoside-binding proteins, have emerged as endogenous mediators that facilitate cell-surface binding, internalization and cell invasion of many sexually transmitted pathogens, including Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Candida albicans, HIV and herpes simplex virus. The ability of certain galectins to dimerize or form multimeric complexes confers the capacity to interact simultaneously with glycosylated ligands on both the pathogen and the cervico-vaginal tissue on these proteins. Galectins can act as a bridge by engaging glycans from the pathogen surface and glycosylated receptors from host cells, which is a mechanism that has been shown to be shared by several sexually transmitted pathogens. In the case of viruses and obligate intracellular bacteria, binding to the cell surface promotes pathogen internalization and cell invasion. Inflammatory responses that occur in cervico-vaginal tissue might trigger secretion of galectins, which in turn control the establishment, evolution and severity of STIs. Thus, galectin-targeted therapies could potentially prevent or decrease STIs caused by a diverse array of pathogenic microorganisms; furthermore, anti-galectin agents might reduce treatment costs of STIs and reach the most vulnerable populations.
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Affiliation(s)
- Agustin L Lujan
- Laboratorio de Bioquímica e Inmunidad, Instituto de Bioquímica y Biotecnología, Facultad de Ciencias Médicas, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Universidad Nacional de Cuyo (UNCUYO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina.,Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Diego O Croci
- Laboratorio de Inmunopatología, Facultad de Ciencias Exactas y Naturales, Instituto de Histología y Embriología de Mendoza (IHEM), Universidad Nacional de Cuyo (UNCUYO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina
| | - Gabriel A Rabinovich
- Laboratorio de Glicomedicina, Instituto de Biología y Medicina Experimental (IBYME), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina. .,Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires (UBA), C1428AGE, Buenos Aires, Argentina.
| | - Maria T Damiani
- Laboratorio de Bioquímica e Inmunidad, Instituto de Bioquímica y Biotecnología, Facultad de Ciencias Médicas, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Universidad Nacional de Cuyo (UNCUYO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina.
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