Perceptions of One's Neighborhood and Mammogram Use among a Sample of Low-Income Women at Risk for Human Immunodeficiency Virus and Sexually Transmitted Infections

Discussion of sexual lifestyle and the ability to take a sexual history are relevant to many types of clinical practice. The age at which people first have sex has decreased and the age at which people start cohabiting has become later in recent decades, increasing the time available to accumulate sexual partners and thus be at risk of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). While many people have few partners, a small proportion of the population has many. People with many partners are most at risk of STIs, but there are many other influences including the gender, age, and ethnicity of their partners and the type of sexual practice. This chapter covers the adverse consequences of sexual behaviour (including STIs and unintended pregnancy), and initiatives to encourage reducing partner numbers, using condoms and effective contraception, and engaging in less risky practices.

Download Full-text

Human Immunodeficiency Virus Pre-exposure Prophylaxis and Increased Incidence of Sexually Transmitted Infections in the United States

Clinical Infectious Diseases ◽

10.1093/cid/ciz552 ◽

2019 ◽

Vol 70 (9) ◽

pp. 1884-1890 ◽

Cited By ~ 1

Author(s):

Jose A Serpa ◽

Gabriel N Huynh ◽

Julie B Nickell ◽

Hongyu Miao

Keyword(s):

United States ◽

Human Immunodeficiency Virus ◽

Sexually Transmitted Infections ◽

State Level ◽

The United States ◽

Incidence Rates ◽

Interrupted Time Series Analysis ◽

Sexually Transmitted ◽

Immunodeficiency Virus ◽

Exposure Prophylaxis

Abstract Background Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) decreases HIV transmission. Some studies have raised concerns about a potential association between the implementation of HIV PrEP and the growing incidence rates of sexually transmitted infections (STIs) in the United States. Methods We conducted a quasi-experimental (interrupted time series) analysis of STI (syphilis, gonorrhea, and chlamydia) rates before (2000–2012) and after (2013–2017) the implementation of HIV PrEP. We also performed correlations between HIV PrEP utilization and STI cases at the national (2012–2017) and state (2017) levels. We defined HIV PrEP utilization as the number of people taking tenofovir disoproxil fumarate/emtricitabine for HIV prevention. Results HIV PrEP implementation was associated with 25% (relative risk [RR] 1.254, 95% confidence interval [CI] 1.245–1.263; P < .001) and 26% (RR 1.260, 95% CI 1.257–1.264; P < .001) increases in syphilis and gonorrhea rates, respectively, and a 12% reduction in chlamydia rates (RR: 0.884, 95% CI 0.883–0.885; P < .001). HIV PrEP utilization was correlated with the numbers of syphilis, gonorrhea, and chlamydia cases (spearman coefficients 1.00, 0.94, and 0.94, respectively; P < .001, P < .01, and P < .01, respectively). At the state level, HIV PrEP was also correlated with the number of cases of syphilis, gonorrhea, and chlamydia (spearman coefficients 0.85, 0.81, and 0.85, respectively; Ps < .001 for all correlations). Conclusions The implementation and utilization of HIV PrEP in the United States were associated with increased rates of STIs. Further studies to confirm these associations and to elucidate potential causes are needed.

Download Full-text