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Ogaz D, Enayat Q, Brown JRG, Phillips D, Wilkie R, Jayes D, Reid D, Hughes G, Mercer CH, Saunders J, Mohammed H. Mpox Diagnosis, Behavioral Risk Modification, and Vaccination Uptake among Gay, Bisexual, and Other Men Who Have Sex with Men, United Kingdom, 2022. Emerg Infect Dis 2024; 30:916-925. [PMID: 38573160 PMCID: PMC11060451 DOI: 10.3201/eid3005.230676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
During the 2022 multicountry mpox outbreak, the United Kingdom identified cases beginning in May. UK cases increased in June, peaked in July, then rapidly declined after September 2022. Public health responses included community-supported messaging and targeted mpox vaccination among eligible gay, bisexual, and other men who have sex with men (GBMSM). Using data from an online survey of GBMSM during November-December 2022, we examined self-reported mpox diagnoses, behavioral risk modification, and mpox vaccination offer and uptake. Among 1,333 participants, only 35 (2.6%) ever tested mpox-positive, but 707 (53%) reported behavior modification to avoid mpox. Among vaccine-eligible GBMSM, uptake was 69% (95% CI 65%-72%; 601/875) and was 92% (95% CI 89%-94%; 601/655) among those offered vaccine. GBMSM self-identifying as bisexual, reporting lower educational qualifications, or identifying as unemployed were less likely to be vaccinated. Equitable offer and provision of mpox vaccine are needed to minimize the risk for future outbreaks and mpox-related health inequalities.
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Sullivan AK, Saunders J, Desai M, Cartier A, Mitchell HD, Jaffer S, Ogaz D, Chiavenna C, Charlett A, Diamente V, Golombek R, Manavi K, Priestley C, Waters LJ, Milinkovic A, McOwan A, Estcourt C, Sabin CA, Rodger A, Gold D, Gazzard BG, McCormack S, Gill ON. HIV pre-exposure prophylaxis and its implementation in the PrEP Impact Trial in England: a pragmatic health technology assessment. Lancet HIV 2023; 10:e790-e806. [PMID: 38040478 DOI: 10.1016/s2352-3018(23)00256-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND HIV pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV acquisition. To enable routine commissioning of PrEP in England, we aimed to establish population need, duration of need, PrEP uptake, and duration of use in attendees of sexual health services (SHS) in England. METHODS The Impact Trial was a prospective, open-label, single-arm, multicentre trial conducted at 157 SHS across England between Oct 13, 2017, and July 12, 2020. Clinicians assessed HIV-negative attendees for their risk of HIV acquisition to identify those who were eligible to participate and receive either daily or event-based oral PrEP (tenofovir disoproxil maleate with emtricitabine), as appropriate. Eligible participants were aged 16 years or older, considered HIV-negative on the day of enrolment, and willing to adhere to the trial procedures. Non-trial attendees are mutually exclusive of trial participants and included SHS attendees who were not recruited to the Impact Trial at any point. They include HIV-negative individuals aged 16 years or older who attended a participating SHS at least once after recruitment at that SHS had begun and before Feb 29, 2020. The main outcomes assessed were PrEP need, uptake, and use, and HIV and sexually transmitted infection (STI) incidence. Data are presented up to Feb 29, 2020, before the introduction of COVID-19 control measures. The study is registered with ClinicalTrials.gov, NCT03253757. FINDINGS In this analysis, we include 21 356 of 24 268 participants enrolled before Feb 29, 2020. 20 403 participants (95·5%) were men who have sex with men (MSM). Uptake of PrEP among SHS attendees clinically assessed and coded as eligible was 21 292 (57·1%) of 37 289. 18 400 trial participants had at least one post-enrolment visit and a median of 361 days of follow-up (IQR 143-638); 14 039 (75·9%) of these had enough PrEP prescribed to provide protection for 75% of their follow-up time. Among MSM, HIV incidence was 0·13 (95% CI 0·08-0·19) per 100 person-years in trial participants (27 seroconversions) and 0·95 (95% CI 0·88-1·03) per 100 person-years in non-trial attendees (587 seroconversions; proportionate reduction of 86·8%, 95% CI 80·2-91·6). 18 607 bacterial STIs were recorded (incidence 68·1 per 100 person-years in trial participants who were MSM). 4343 (24·4%) MSM participants were diagnosed with two or more STIs, accounting for 14 800 (79·5%) of all 18 607 diagnoses. INTERPRETATION PrEP need was higher than initially estimated by an expert stakeholder group. The high proportion of follow-up time protected by PrEP suggests that the need for protection persisted throughout trial participation for most participants. HIV incidence among MSM trial participants was low. The large unmet need for PrEP suggests that greater provision is required to maximise the potential of a national programme. The high incidence of bacterial STIs among participants, concentrated within a subgroup of PrEP users, presents an opportunity for tailored STI control measures. FUNDING NHS England.
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Affiliation(s)
- Ann K Sullivan
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK; UK Health Security Agency, London, UK.
| | - John Saunders
- UK Health Security Agency, London, UK; University College London, London, UK; National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, London, UK
| | | | - Andrea Cartier
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK
| | | | - Sajjida Jaffer
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK
| | - Dana Ogaz
- UK Health Security Agency, London, UK
| | | | | | - Victor Diamente
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK
| | - Rainer Golombek
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK
| | - Kaveh Manavi
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Laura J Waters
- Central and North West London NHS Foundation Trust, London, UK
| | - Ana Milinkovic
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK
| | - Alan McOwan
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK
| | | | - Caroline A Sabin
- University College London, London, UK; National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, London, UK
| | | | | | - Brian G Gazzard
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK
| | - Sheena McCormack
- Chelsea and Westminster Hospital National Health Service (NHS) Foundation Trust, London, UK; University College London, London, UK
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Brown JR, Reid D, Howarth AR, Mohammed H, Saunders J, Pulford CV, Ogaz D, Hughes G, Mercer CH. Sexual behaviour, STI and HIV testing and testing need among gay, bisexual and other men who have sex with men recruited for online surveys pre/post-COVID-19 restrictions in the UK. Sex Transm Infect 2023; 99:467-473. [PMID: 36858811 DOI: 10.1136/sextrans-2022-055689] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 11/09/2022] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVES We examined sexual behaviour, sexually transmitted infection (STI) and HIV testing and testing need, and identified associated factors, among gay, bisexual and other men who have sex with men (GBMSM) in the UK after COVID-19 restrictions ended, and compared these with 'pre-pandemic' estimates. METHODS We analysed survey data from GBMSM (N=1039) recruited via social media and Grindr in November-December 2021. We then compared Grindr-recruited 2021 participants (N=437) with those from an equivalent survey fielded in March-May 2017 (N=1902). Questions on sexual behaviour and service use had lookback periods of 3-4 months in both surveys. Unmet testing need was defined as reporting any new male and/or multiple condomless anal sex (CAS) partners without recent STI/HIV testing. Participants were UK residents, GBMSM, aged ≥16 years who reported sex with men in the last year. Multivariable logistic regression identified associated sociodemographic and health-related factors with unmet STI/HIV testing need in 2021, and then for 2017/2021 comparative analyses, adjusting for demographic differences. RESULTS In 2021, unmet STI and HIV testing need were greater among older GBMSM (aged ≥45 years vs 16-29 years; adjusted OR (aOR): 1.45 and aOR: 1.77, respectively), and lower for pre-exposure prophylaxis (PrEP) users (vs non-PrEP users; aOR: 0.32 and aOR: 0.23, respectively). Less unmet STI testing need was observed among HIV-positive participants (vs HIV-negative/unknown; aOR: 0.63), and trans and non-binary participants (vs cisgender male; aOR: 0.34). Between 2017 (reference) and 2021, reported sexual risk behaviours increased: ≥1 recent new male sex partner (72.1%-81.1%, aOR: 1.71) and ≥2 recent CAS partners (30.2%-48.5%, aOR: 2.22). Reporting recent STI testing was greater in 2021 (37.5%-42.6%, aOR: 1.34) but not recent HIV testing, and there was no significant change over time in unmet STI (39.2% vs 43.7%) and HIV (32.9% vs 39.0%) testing need. DISCUSSION Comparable community surveys suggest that UK resident GBMSM may have engaged in more sexual risk behaviours in late 2021 than pre-pandemic. While there was no evidence of reduced STI/HIV service access during this time, there remained considerable unmet STI/HIV testing need.
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Affiliation(s)
- Jack Rg Brown
- Institute for Global Health, University College London, London, UK
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - David Reid
- Institute for Global Health, University College London, London, UK
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - Alison R Howarth
- Institute for Global Health, University College London, London, UK
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
| | - Hamish Mohammed
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - John Saunders
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Caisey V Pulford
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Dana Ogaz
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Gwenda Hughes
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Catherine H Mercer
- Institute for Global Health, University College London, London, UK
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the UK Health Security Agency, London, UK
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Ogaz D, Allen H, Reid D, Brown JRG, Howarth AR, Pulford CV, Mercer CH, Saunders J, Hughes G, Mohammed H. COVID-19 infection and vaccination uptake in men and gender-diverse people who have sex with men in the UK: analyses of a large, online community cross-sectional survey (RiiSH-COVID) undertaken November-December 2021. BMC Public Health 2023; 23:829. [PMID: 37147609 PMCID: PMC10161154 DOI: 10.1186/s12889-023-15779-5] [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: 01/19/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Men and gender-diverse people who have sex with men are disproportionately affected by health conditions associated with increased risk of severe illness due to COVID-19 infection. METHODS An online cross-sectional survey of men and gender-diverse people who have sex with men in the UK recruited via social networking and dating applications from 22 November-12 December 2021. Eligible participants included self-identifying men, transgender women, or gender-diverse individuals assigned male at birth (AMAB), aged ≥ 16, who were UK residents, and self-reported having had sex with an individual AMAB in the last year. We calculated self-reported COVID-19 test-positivity, proportion reporting long COVID, and COVID-19 vaccination uptake anytime from pandemic start to survey completion (November/December 2021). Logistic regression was used to assess sociodemographic, clinical, and behavioural characteristics associated with SARS-CoV-2 (COVID-19) test positivity and complete vaccination (≥ 2 vaccine doses). RESULTS Among 1,039 participants (88.1% white, median age 41 years [interquartile range: 31-51]), 18.6% (95% CI: 16.3%-21.1%) reported COVID-19 test positivity, 8.3% (95% CI: 6.7%-10.1%) long COVID, and 94.5% (95% CI: 93.3%-96.1%) complete COVID-19 vaccination through late 2021. In multivariable models, COVID-19 test positivity was associated with UK country of residence (aOR: 2.22 [95% CI: 1.26-3.92], England vs outside England) and employment (aOR: 1.55 [95% CI: 1.01-2.38], current employment vs not employed). Complete COVID-19 vaccination was associated with age (aOR: 1.04 [95% CI: 1.01-1.06], per increasing year), gender (aOR: 0.26 [95% CI: 0.09-0.72], gender minority vs cisgender), education (aOR: 2.11 [95% CI: 1.12-3.98], degree-level or higher vs below degree-level), employment (aOR: 2.07 [95% CI: 1.08-3.94], current employment vs not employed), relationship status (aOR: 0.50 [95% CI: 0.25-1.00], single vs in a relationship), COVID-19 infection history (aOR: 0.47 [95% CI: 0.25-0.88], test positivity or self-perceived infection vs no history), known HPV vaccination (aOR: 3.32 [95% CI: 1.43-7.75]), and low self-worth (aOR: 0.29 [95% CI: 0.15-0.54]). CONCLUSIONS In this community sample, COVID-19 vaccine uptake was high overall, though lower among younger age-groups, gender minorities, and those with poorer well-being. Efforts are needed to limit COVID-19 related exacerbation of health inequalities in groups who already experience a greater burden of poor health relative to other men who have sex with men.
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Affiliation(s)
- Dana Ogaz
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK.
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK.
| | - Hester Allen
- COVID-19 Vaccines and Epidemiology Division, UK Health Security Agency, London, UK
| | - David Reid
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
- Sigma Research, Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Jack R G Brown
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Alison R Howarth
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Caisey V Pulford
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
| | - Catherine H Mercer
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - John Saunders
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Gwenda Hughes
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
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Brown JR, Reid D, Howarth AR, Mohammed H, Saunders J, Pulford CV, Ogaz D, Hughes G, Mercer CH. Difficulty accessing condoms because of the COVID-19 pandemic reported by gay, bisexual and other men who have sex with men in the UK: findings from a large, cross-sectional, online survey. Int J STD AIDS 2023:9564624231160804. [PMID: 36943893 PMCID: PMC10031272 DOI: 10.1177/09564624231160804] [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: 03/23/2023]
Abstract
BACKGROUND COVID-19 restrictions severely reduced face-to-face sexual health services, an important access point for condoms. We examine whether gay, bisexual and other men who have sex with men (GBMSM) in the UK had difficulty accessing condoms during the first year of the pandemic, and if so, which groups were most affected. METHODS Questions about difficulty accessing condoms were asked as part of a short, online cross-sectional survey of GBMSM undertaken November/December 2021, recruited via social media and Grindr. Eligible participants were UK-resident GBMSM (cis/trans/gender-diverse person assigned male at birth [AMAB]), aged ≥16 years who were sexually active (reported sex with men in the last year). Multivariable logistic regression was used to examine if and how reporting this outcome varied by key sociodemographic, health and behavioural factors independent of the potential confounding effect of numbers of new male sex partners. RESULTS Of all participants (N = 1039), 7.4% (n = 77) reported difficulty accessing condoms due to the pandemic. This was higher among younger GBMSM (aged 16-29 years vs. ≥45; 12.8% vs. 4.9%; aOR: 2.78); trans/gender-diverse AMAB participants (vs. cis gender males; 24.4% vs. 6.6%; aOR = 4.86); bisexually-identifying participants (vs. gay-identifying; 11.1% vs. 6.5%; aOR = 1.78); and those without degree level education (vs. having a degree; 9.8% vs. 5.6%; aOR = 2.01). CONCLUSIONS A minority of sexually active GBMSM reported difficulty accessing condoms because of the pandemic, however, this was more common amongst those who already experience a disproportionate burden of poor sexual health. Interventions are needed to address these inequalities in accessing this important primary STI/HIV prevention measure.
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Affiliation(s)
- Jack Rg Brown
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
| | - David Reid
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
| | - Alison R Howarth
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
| | - Hamish Mohammed
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, 371011the UK Health Security Agency, Colindale, UK
| | - John Saunders
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, 371011the UK Health Security Agency, Colindale, UK
| | - Caisey V Pulford
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, 371011the UK Health Security Agency, Colindale, UK
| | - Dana Ogaz
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Blood Safety, Hepatitis, STIs and HIV Division, 371011the UK Health Security Agency, Colindale, UK
| | - Gwenda Hughes
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Catherine H Mercer
- Institute for Global Health, 4919University College London, London, UK
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK
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Bradshaw D, Khawar A, Patel P, Tosswill J, Brown C, Ogaz D, Mason E, Osman R, Mitchell H, Dosekun O, Peris BM, Pickard G, Rayment M, Jones R, Hopkins M, Williams A, Kingston M, Machin N, Taha Y, Duncan S, Turner N, Gill N, Andrews N, Raza M, Tazzyman S, Nori A, Cunningham E, Taylor GP. HTLV seroprevalence in people using HIV pre-exposure prophylaxis in England. J Infect 2023; 86:245-247. [PMID: 36773896 DOI: 10.1016/j.jinf.2023.01.033] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/05/2023] [Accepted: 01/20/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES HTLV-1 is predominantly a sexually-transmitted infection but testing is not mentioned in HIV-PrEP guidelines. We ascertained HTLV-1/HTLV-2 seroprevalence amongst HIV-PrEP users in England. METHODS An unlinked anonymous seroprevalence study. RESULTS Amongst 2015 HIV-PrEP users, 95% were men, 76% of white ethnicity and 83% had been born in Europe. There were no HTLV-1/HTLV-2 seropositive cases (95% confidence interval 0% - 0.18%). CONCLUSIONS There were no HTLV positive cases, likely reflecting the demographic of mostly white and European-born individuals. Similar studies are needed worldwide to inform public health recommendations for HIV-PrEP using populations, particularly in HTLV-endemic settings.
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Affiliation(s)
- Daniel Bradshaw
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK; National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London W2 1NY, UK.
| | - Arham Khawar
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Poorvi Patel
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | | | - Colin Brown
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Dana Ogaz
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Emily Mason
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Roeann Osman
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Holly Mitchell
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Olamide Dosekun
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London W2 1NY, UK
| | - Borja Mora Peris
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London W2 1NY, UK
| | - Graham Pickard
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London W2 1NY, UK
| | - Michael Rayment
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK
| | - Rachael Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK
| | - Mark Hopkins
- Barts Health NHS Trust, St Bartholomew's Hospital, London EC1A 7BE, UK
| | - Andy Williams
- Barts Health NHS Trust, St Bartholomew's Hospital, London EC1A 7BE, UK
| | - Margaret Kingston
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - Nicholas Machin
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - Yusri Taha
- Newcastle Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle NE1 4LP, UK
| | - Sarah Duncan
- Newcastle Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle NE1 4LP, UK
| | - Neil Turner
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK
| | - Noel Gill
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Nick Andrews
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Mohammad Raza
- Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield S10 2JF, UK
| | - Simon Tazzyman
- Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield S10 2JF, UK
| | - Achyuta Nori
- Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK
| | - Emma Cunningham
- Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK
| | - Graham P Taylor
- Imperial College London, London W2 1PG, UK; National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London W2 1NY, UK
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Ogaz D, Logan L, Curtis TJ, McDonagh L, Guerra L, Bradshaw D, Patel P, Macri C, Murphy G, Noel Gill O, Johnson AM, Nardone A, Burns F. PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019. BMC Public Health 2022; 22:1105. [PMID: 35659209 PMCID: PMC9163522 DOI: 10.1186/s12889-022-13425-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Access to prevention options, including HIV pre-exposure prophylaxis (PrEP), remains a public health priority for gay, bisexual, and other men who have sex with men (MSM), especially in London. We describe PrEP use in a London community sample of MSM before the introduction of a national PrEP programme in October 2020. Methods From June–August 2019, MSM aged ≥ 18 recruited from London commercial venues were asked to self-complete a sexual health questionnaire and provide an oral fluid sample for anonymous HIV antibody testing. Descriptive analyses of demographic characteristics, service engagement and outcomes, as well as sexual risk and prevention behaviours were examined in the survey population and in those reporting current PrEP use. We performed sequential, multivariate analyses examining current PrEP use in MSM of self-perceived HIV-negative/unknown status with identified PrEP-need defined as the report of condomless anal sex (CAS) in the last three months, or the report of CAS (in the last year) with an HIV-positive/unknown status partner not known to be on HIV treatment, in reflection of UK PrEP guidelines. Results One thousand five hundred and thirty-fifth questionnaires were completed across 34 venues, where 1408 were analysed. One in five MSM of self-perceived HIV-negative/unknown status reported current PrEP use (19.7%, 242/1230). In men with PrEP-need, 68.2% (431/632) did not report current use. Current PrEP use was associated with age (aOR: 3.52, 95% CI: 1.76–7.02 in men aged 40–44 vs men aged 18–25) and education (aOR: 1.72, 95% CI: 1.01–2.92 in men with ≥ 2 years/still full-time vs no/ < 2 years of education since age 16). Conclusion Among MSM in London, PrEP use is high but there is indication of unmet PrEP-need in men of younger age and lower levels of post-16 education. National programme monitoring and evaluation will require continued community monitoring to guide interventions ensuring equitable PrEP access and uptake in those who could most benefit from PrEP. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13425-0.
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8
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Girometti N, Delpech V, McCormack S, Khawam J, Nash S, Ogaz D, Mohammed H, Gedela K, Nugent D, Patel S, Suchak T, Tittle V, McOwan A, Whitlock G. The success of HIV combination prevention: The Dean Street model. HIV Med 2021; 22:892-897. [PMID: 34323336 DOI: 10.1111/hiv.13149] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
The 56 Dean Street combination prevention model, a strong engagement with the LGBTQI community and flexible services adapted to users' changing needs led to an 80% drop in HIV diagnoses in gay, bisexual and other men who have sex with men (GBMSM) from 2015 to 2017. We describe the service changes at 56 Dean Street since 2012 which resulted in an increase in the frequency of HIV testing, the introduction of pre-exposure prophylaxis, earlier HIV diagnosis and a shorter time to viral suppression in those living with HIV. This model could be adapted to deliver similar results in those settings of high HIV prevalence among GBMSM and where access to technological innovation in healthcare and engagement with the community can be achieved.
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Affiliation(s)
| | - Valerie Delpech
- Blood Safety, Hepatitis, STIs and HIV Directorate, Centre for Infections, Public Health England, London, UK
| | - Sheena McCormack
- Chelsea & Westminster Hospital NHS Foundation Trust, London, UK.,Imperial College, London, UK
| | - Jameel Khawam
- Blood Safety, Hepatitis, STIs and HIV Directorate, Centre for Infections, Public Health England, London, UK
| | - Sophie Nash
- Blood Safety, Hepatitis, STIs and HIV Directorate, Centre for Infections, Public Health England, London, UK
| | - Dana Ogaz
- Blood Safety, Hepatitis, STIs and HIV Directorate, Centre for Infections, Public Health England, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, STIs and HIV Directorate, Centre for Infections, Public Health England, London, UK
| | - Keerti Gedela
- Chelsea & Westminster Hospital NHS Foundation Trust, London, UK
| | - Diarmuid Nugent
- Chelsea & Westminster Hospital NHS Foundation Trust, London, UK
| | - Sheel Patel
- Chelsea & Westminster Hospital NHS Foundation Trust, London, UK
| | - Tara Suchak
- Chelsea & Westminster Hospital NHS Foundation Trust, London, UK
| | - Victoria Tittle
- Chelsea & Westminster Hospital NHS Foundation Trust, London, UK
| | - Alan McOwan
- Chelsea & Westminster Hospital NHS Foundation Trust, London, UK
| | - Gary Whitlock
- Chelsea & Westminster Hospital NHS Foundation Trust, London, UK
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9
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Brizzi F, Birrell PJ, Kirwan P, Ogaz D, Brown AE, Delpech VC, Gill ON, De Angelis D. Tracking elimination of HIV transmission in men who have sex with men in England: a modelling study. Lancet HIV 2021; 8:e440-e448. [PMID: 34118196 PMCID: PMC8238681 DOI: 10.1016/s2352-3018(21)00044-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/03/2021] [Accepted: 02/18/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND To manage the HIV epidemic among men who have sex with men (MSM) in England, treatment as prevention strategies based on test and treat were strengthened between 2011 and 2015, and supplemented from 2015 by scale-up of pre-exposure prophylaxis (PrEP). We examined the effect of these interventions on HIV incidence and investigated whether internationally agreed targets for HIV control and elimination of HIV transmission by 2030 might be within reach among MSM in England. METHODS We used a novel, age-stratified, CD4-staged Bayesian back-calculation model to estimate HIV incidence and undiagnosed infections among adult MSM (age ≥15 years) during the 10-year period between 2009 and 2018. The model used data on HIV and AIDS diagnoses routinely collected via the national HIV and AIDS Reporting System in England, and knowledge on the progression of HIV through CD4-defined disease stages. Estimated incidence trends were extrapolated, assuming a constant MSM population from 2018 onwards, to quantify the likelihood of achieving elimination of HIV transmission, defined as less than one newly aquired infection per 10 000 MSM per year, by 2030. FINDINGS The peak in HIV incidence in MSM in England was estimated with 80% certainty to have occurred in 2012 or 2013, at least 1 year before the observed peak in new diagnoses in 2014. Results indicated a steep decrease in the annual number of new infections among MSM, from 2770 (95% credible interval 2490-3040) in 2013 to 1740 (1500-2010) in 2015, followed by a steadier decrease from 2016, down to 854 (441-1540) infections in 2018. A decline in new infections was consistently estimated in all age groups, and was particularly marked in MSM aged 25-34 years, and slowest in those aged 45 years or older. Similar trends were estimated in the number of undiagnosed infections, with the greatest decrease after 2013 in the 25-34 years age group. Under extrapolation assumptions, we calculated a 40% probability of achieving the defined target elimination threshold by 2030. INTERPRETATION The sharp decrease in HIV incidence, estimated to have begun before the scale up of PrEP, indicates the success of strengthening treatment as prevention measures among MSM in England. To achieve the 2030 elimination threshold, targeted policies might be required to reach those aged 45 years or older, in whom incidence is decreasing at the slowest rate. FUNDING UK Medical Research Council, UK National Institute of Health Research Health Protection Unit in Behavioural Science and Evaluation, and Public Health England.
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Affiliation(s)
- Francesco Brizzi
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Paul J Birrell
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK; National Infection Service, Public Health England, Colindale, UK
| | - Peter Kirwan
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK; National Infection Service, Public Health England, Colindale, UK
| | - Dana Ogaz
- National Infection Service, Public Health England, Colindale, UK
| | - Alison E Brown
- National Infection Service, Public Health England, Colindale, UK
| | | | - O Noel Gill
- National Infection Service, Public Health England, Colindale, UK
| | - Daniela De Angelis
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK.
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Saunders J, Mohammed H, Daskalopoulou M, Ogaz D, Gill ON, Sullivan A. Re
sponse to: Fitzpatrick C, Lowe M, Richardson D. Sexually transmitted infection testing and rates in men who have sex with men (
MSM
) using
HIV
pre‐exposure prophylaxis.
HIV
Medicine
2019; https://doi.org/10.1111/hiv.12736 (published Online First: 16 March 2019). HIV Med 2019; 20:e18-e19. [DOI: 10.1111/hiv.12776] [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] [Indexed: 11/27/2022]
Affiliation(s)
- John Saunders
- Blood Safety, Hepatitis, STI and HIV Division, National Infection Service Public Health England London UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, STI and HIV Division, National Infection Service Public Health England London UK
| | - Marina Daskalopoulou
- Blood Safety, Hepatitis, STI and HIV Division, National Infection Service Public Health England London UK
| | - Dana Ogaz
- Blood Safety, Hepatitis, STI and HIV Division, National Infection Service Public Health England London UK
| | - O Noel Gill
- Blood Safety, Hepatitis, STI and HIV Division, National Infection Service Public Health England London UK
| | - Ann Sullivan
- Blood Safety, Hepatitis, STI and HIV Division, National Infection Service Public Health England London UK
- Chelsea and Westminster Hospital London UK
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11
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Brown AE, Nash S, Connor N, Kirwan PD, Ogaz D, Croxford S, Angelis DD, Delpech VC. Towards elimination of HIV transmission, AIDS and HIV-related deaths in the UK. HIV Med 2018; 19:505-512. [PMID: 29923668 DOI: 10.1111/hiv.12617] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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] [Accepted: 03/06/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Our objective was to present recent trends in the UK HIV epidemic (2007-2016) and the public health response. METHODS HIV diagnoses and clinical markers were extracted from the HIV and AIDS Reporting System; HIV testing data in sexual health services (SHS) were taken from GUMCAD STI Surveillance System. HIV data were modelled to estimate the incidence in men who have sex with men (MSM) and post-migration HIV acquisition in heterosexuals. Office for National Statistics (ONS) data enabled mortality rates to be calculated. RESULTS New HIV diagnoses have declined in heterosexuals as a result of decreasing numbers of migrants from high HIV prevalence countries entering the UK. Among MSM, the number of HIV diagnoses fell from 3570 in 2015 to 2810 in 2016 (and from 1554 to 1096 in London). Preceding the decline in HIV diagnoses, modelled estimates indicate that transmission began to fall in 2012, from 2800 [credible interval (CrI) 2300-3200] to 1700 (CrI 900-2700) in 2016. The crude mortality rate among people promptly diagnosed with HIV infection was comparable to that in the general population (1.22 vs. 1.39 per 1000 aged 15-59 years, respectively). The number of MSM tested for HIV at SHS increased annually; 28% of MSM who were tested in 2016 had been tested in the preceding year. In 2016, 76% of people started antiretroviral therapy within 90 days of diagnosis (33% in 2007). CONCLUSIONS The dual successes of the HIV transmission decline in MSM and reduced mortality are attributable to frequent HIV testing and prompt treatment (combination prevention). Progress towards the elimination of HIV transmission, AIDS and HIV-related deaths could be achieved if combination prevention, including pre-exposure prophylaxis, is replicated for all populations.
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Affiliation(s)
- A E Brown
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - S Nash
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - N Connor
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - P D Kirwan
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - D Ogaz
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - S Croxford
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | | | - V C Delpech
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
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12
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Mohammed H, Blomquist P, Ogaz D, Duffell S, Furegato M, Checchi M, Irvine N, Wallace LA, Thomas DR, Nardone A, Dunbar JK, Hughes G. 100 years of STIs in the UK: a review of national surveillance data. Sex Transm Infect 2018; 94:553-558. [DOI: 10.1136/sextrans-2017-053273] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/02/2018] [Accepted: 03/24/2018] [Indexed: 11/04/2022] Open
Abstract
ObjectivesThe 1916 Royal Commission on Venereal Diseases was established in response to epidemics of syphilis and gonorrhoea in the UK. In the 100 years since the Venereal Diseases Act (1917), the UK has experienced substantial scientific, economic and demographic changes. We describe historical and recent trends in STIs in the UK.MethodsWe analysed surveillance data derived from STI clinics’ statistical returns from 1917 to 2016.ResultsSince 1918, gonorrhoea and syphilis diagnoses have fluctuated, reflecting social, economic and technological trends. Following spikes after World Wars I and II, rates declined before re-emerging during the 1960s. At that time, syphilis was more common in men, suggestive of transmission within the men who have sex with men (MSM) population. Behaviour change following the emergence of HIV/AIDS in the 1980s is thought to have facilitated a precipitous decline in diagnoses of both STIs in the mid-1980s. Since the early 2000s, gonorrhoea and syphilis have re-emerged as major public health concerns due to increased transmission among MSM and the spread of antimicrobial-resistant gonorrhoea. Chlamydia and genital warts are now the most commonly diagnosed STIs in the UK and have been the focus of public health interventions, including the national human papillomavirus vaccination programme, which has led to substantial declines in genital warts in young people, and the National Chlamydia Screening Programme in England. Since the 1980s, MSM, black ethnic minorities and young people have experienced the highest STI rates.ConclusionAlthough diagnoses have fluctuated over the last century, STIs continue to be an important public health concern, often affecting more marginalised groups in society. Prevention must remain a public health priority and, as we enter a new era of sexual healthcare provision including online services, priority must be placed on maintaining prompt access for those at greatest risk of STIs.
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13
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Brown AE, Mohammed H, Ogaz D, Kirwan PD, Yung M, Nash SG, Furegato M, Hughes G, Connor N, Delpech VC, Gill ON. Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PrEP)? ACTA ACUST UNITED AC 2017; 22:30553. [PMID: 28662762 PMCID: PMC5490453 DOI: 10.2807/1560-7917.es.2017.22.25.30553] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [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: 06/12/2017] [Accepted: 06/20/2017] [Indexed: 11/27/2022]
Abstract
Since October 2015 up to September 2016, HIV diagnoses fell by 32% compared with October 2014–September 2015 among men who have sex with men (MSM) attending selected London sexual health clinics. This coincided with high HIV testing volumes and rapid initiation of treatment on diagnosis. The fall was most apparent in new HIV testers. Intensified testing of high-risk populations, combined with immediately received anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) programme, may make elimination of HIV achievable.
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Affiliation(s)
- Alison E Brown
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom.,These authors contributed equally to this work and share first authorship
| | - Hamish Mohammed
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom.,These authors contributed equally to this work and share first authorship
| | - Dana Ogaz
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
| | - Peter D Kirwan
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
| | - Mandy Yung
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
| | - Sophie G Nash
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
| | - Martina Furegato
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
| | - Gwenda Hughes
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
| | - Nicky Connor
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
| | - Valerie C Delpech
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
| | - O Noel Gill
- HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom
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14
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Furegato M, Mitchell H, Ogaz D, Woodhall S, Connor N, Hughes G, Nardone A, Mohammed H. The role of frequent HIV testing in diagnosing HIV in men who have sex with men. HIV Med 2017; 19:118-122. [PMID: 28984407 DOI: 10.1111/hiv.12558] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 07/26/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In the UK, quarterly HIV testing is recommended for high-risk men who have sex with men (MSM). In this manuscript we determined the risk of being newly diagnosed with HIV in MSM by their HIV testing history, considering both the frequency and periodicity of testing. METHODS Data on HIV incidence in MSM attending a sexual health clinic (SHC) in England in 2013-2014 with testing history (previous 2 years) were obtained from GUMCAD, the national sexually transmitted infection (STI) surveillance system in England. HIV testing patterns among MSM were defined using the frequency and periodicity of testing, based on 3 month intervals, in the year preceding the first attendance during the study period. Cox proportional hazards regression was used to determine the association between HIV testing pattern and time to HIV diagnosis with and without adjustment for demographic confounders. Analyses were stratified by risk stratum, with 'high risk' defined as a history of a bacterial STI in the past year. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) are reported. RESULTS Among the 37 702 HIV-negative MSM attending an SHC in 2013-2014, 1105 (3%) were diagnosed with HIV infection within 1 year of their first attendance. The probability of HIV diagnosis was highest in MSM who were tested quarterly compared with those who were not tested in the past year (aHR 2.51; 95% CI 1.33-4.74); this increased 1.8-fold among high-risk MSM (aHR 4.48; 95% CI 0.97-21.17). CONCLUSIONS The probability of subsequent HIV diagnosis was greatest in high-risk MSM who were tested most frequently. Quarterly HIV testing increased the likelihood of identifying undiagnosed HIV infection and should remain a continued recommendation for high-risk MSM.
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Affiliation(s)
- M Furegato
- National Infection Service, Public Health England, London, UK
| | - H Mitchell
- National Infection Service, Public Health England, London, UK
| | - D Ogaz
- National Infection Service, Public Health England, London, UK
| | - S Woodhall
- National Infection Service, Public Health England, London, UK
| | - N Connor
- National Infection Service, Public Health England, London, UK
| | - G Hughes
- National Infection Service, Public Health England, London, UK
| | - A Nardone
- National Infection Service, Public Health England, London, UK
| | - H Mohammed
- National Infection Service, Public Health England, London, UK
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15
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Affiliation(s)
- G Ireland
- National Infection Service, Public Health England, London, UK
| | - D Ogaz
- National Infection Service, Public Health England, London, UK
| | - P Kirwan
- National Infection Service, Public Health England, London, UK
| | - S Mandal
- National Infection Service, Public Health England, London, UK
| | - V Delpech
- National Infection Service, Public Health England, London, UK
| | - N Connor
- National Infection Service, Public Health England, London, UK
| | - R Simmons
- National Infection Service, Public Health England, London, UK
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16
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Coronado GD, O'Connell MA, Anderson J, Löest H, Ogaz D, Thompson B. Undergraduate cancer training program for underrepresented students: findings from a minority institution/cancer center partnership. J Cancer Educ 2010; 25:32-5. [PMID: 20082168 PMCID: PMC2914793 DOI: 10.1007/s13187-009-0006-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2007] [Revised: 01/18/2008] [Accepted: 10/17/2009] [Indexed: 05/11/2023]
Abstract
Students from racially/ethnically diverse backgrounds are underrepresented in graduate programs in biomedical disciplines. One goal of the Minority Institution/Cancer Center partnership between New Mexico State University (NMSU) and the Fred Hutchinson Cancer Research Center (FHCRC) is to expand the number of underrepresented students who are trained in cancer research. As part of the collaboration, a summer internship program has been organized at the FHCRC. The program runs for 9 weeks and involves mentored research, research seminars, coffee breaks, social activities, and a final poster session. This study examined the graduate school attendance rates of past interns, explored interns' perceptions of the training program, and identified ways to improve the program. Thirty undergraduate students enrolled at NMSU participated in the internship program from 2002 to 2007 and telephone interviews were conducted on 22 (73%) of them. One-third of the students were currently in graduate school (32%); the remaining were either working (36%), still in undergraduate school (27%), or unemployed and not in school (5%). Students rated highly the following aspects of the program: mentored research, informal time spent with mentors, and research seminars. Students also reported the following activities would further enhance the program: instruction on writing a personal statement for graduate school and tips in choosing an advisor. Students also desired instruction on taking the GRE/MCAT, receiving advice on selecting a graduate or professional school, and receiving advice on where to apply. These findings can inform the design of internship programs aimed at increasing rates of graduate school attendance among underrepresented students.
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Affiliation(s)
- Gloria D Coronado
- Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, P.O. Box 19024, 1100 Fairview Ave. N; M3-B232, Seattle, WA 98109, USA.
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